Transcript The Emergency Care Summary Dr Ian Kerr

The Emergency Care Summary
NMAHP Meeting
6th March
2007
The Emergency
Care
Summary
Dr Ian Kerr
Dr Ian Kerr
Dr Libby Morris
SCI DC
Diabetes
network
SCI gateway
referrals
GP SYSTEMS
EMIS 45
INPS 55
GPASS 850
ISOFT 35
ASCRIBE 15
SCI store
Lab results
Background
• The new GP contract
meant changes to Out
of Hours (OOH)
arrangements
• A “useful summary”
was needed for OOH
services
– A&E, Ambulance,
NHS24
Emergency Care Summary
• Patient information is copied from Practice
Computer systems
• Sent to SCI-store twice daily
• The information is ‘Read only’ and
available for OOHs clinicians
• NHS 24 will be linked in June 2007
Agreed Dataset
• Patient demographics (address,
telephone, CHI number)
• Allergies and Adverse reactions to
medications
• Medication history
-repeat prescriptions and
-acute prescriptions in past 30 days
• Consent Flag (patients can opt out)
S E C S Security
• Access and security controls with
passwords and logon for all clinicians
• Patients must give permission for the
clinician to view their records.
• Practices can check who has accessed their
patients’ records with web based
• Audit controls run regularly
System Overview
PRACTICE
GP
consultation
ECS update
OOH
clinician
ECS summary
request &
display
ECS
System
Practice Admin.
Staff
NHS
24
A&E
Ambulance
1. During consultation
Who saw
who2.forDue to prescription
practice?
3. Other Patient contact
TBD…
Warning to clinicians before viewing
• You must ask the patient for permission before viewing their clinical
data.
• Your details will be recorded and monitored, and the patient's practice
will be able to see that you have looked at this record.
• This record shows all prescriptions issued by the GP clinical system in
the last year. It may not include handwritten prescriptions, or drugs
prescribed by other prescribers in other clinics.
• Allergies will be indicated if known and recorded. The patient should be
asked by the clinician if he/she is aware of any new or unrecorded
allergies.
• It is good practice to check the accuracy of this data with the patient
Patients Search Results
Patient Record – Medical Details
Patient Record – Consent
Withheld
ECS Access Report
Patients’ Views of ECS
• 8 focus groups were held in Scotland
• 6 members of the public
• 2 groups of people living with HIV and
mental health problems
Key findings
• Patients generally supportive of ECS
• Main concerns related to security and who would
access the ECS
• Patients wanted to be informed and have the
chance to opt-out
• Most thought they should have the right to see
their ECS
• Recognition of advantages of single patient record
with concerns about confidentiality
New Developments
• A pilot study has been carried out in two A/E
departments in Ayrshire.
• Initial evaluation shows that this was extremely
successful, there were a large number of patients
ECS records accessed, and clinical staff found
the information useful, esp with patients who
had taken an overdose of medication.
Publicity Campaign
•
•
•
•
•
•
•
Letter to all GPs and Practice Managers
Leaflet sent to every household in Scotland
Helpline dedicated to enquiries
180 calls in first week
Opt out, general enquiries, odd requests
Very few requests to view records
Very few opt outs
Forth Valley
Glasgow
Grampian
Highland
Lanarkshire
Lothian
Orkney
Shetland
Tayside
Western Isles
NHS24
Totals
36
29
157
745
-
-
209
231
17
7
161
186
280
245
409
413
277
227
558
427
-
-
22
853
-
-
4
3
1
0
1
0
-
-
69
1289
28
24
31
25
-
-
2813
2521
2959
7898
10456
3329
Total Number of Patients
4956535
Patients Withdrawn Consent
496
The Future of SECS ???
•
•
•
•
•
Integration with NHS24, A&E, Ambulance Service
Clinician inter-Health Board patient data access
Shared palliative care forms
Lab results
Extension of data set
Contact details
[email protected]