Transcript Records Sharing GIG 170914

Get Involved Group
Records Sharing to Support
High Quality Care
Becky Gayler
Clinical Informatics Project Manager
17th September 2014
The CCG is working to
Ensure that high quality information is available where and
when needed to support you, and the health professionals
treating you, to make good decisions about your health and
care, to….
 improve patient safety, health and experience
 reduce inequalities
 improve efficiency
Where are we now?
“Patients, carers and the information to support
them are the most under-utilised resources the NHS
has available.”
NHS needs to make better use of information:
• to provide high quality care when increasing pressure on resources
• to avoid fragmentation, to integrate care and make it personalised
Where do we want to be?
“The Power of Information” 2012 ambitions:
• Information used to drive integrated care within
and between organisations;
• Information recorded once on computer, and
shared securely to support care;
• A culture of transparency: access to high-quality,
evidence-based information about services
• Innovative and integrated solutions,
• Using national standards which allow information
to move freely, safely, and securely.
Our Vision
has the Patient at the Centre
Types of Records Sharing
1. Sharing for planning and research
2. Sharing to support your urgent and
emergency care
3. Sharing to support your local
planned care
4. Having access to your own medical
(GP) record
Benefits of Sharing
• Better decisions about your care
– Improved safety
– More appropriate care
– Continuity of care maintained
• Better patient experience
– Appropriate care delivered quicker
– Better patient experience – wishes respected
– Less need to repeat procedures e.g. tests
– Care delivered closer to home
What’s happening locally?
Key Areas of Work
1. Providing you with online access to:
a. see information in your GP record
b. order repeat medications and book appointments
c. contact health professionals
d. obtain information about lifestyle and treatment choices.
2. Sharing relevant information (including GP
records) with health professionals treating you. This
will include care plans agreed with your health professional,
to help you and those supporting you, manage your day-today health and setting out what should happen if you do
become more unwell or need urgent care.
Right Information,
Right Place, Right Time
Already happening…..
• Summary Care Records: summary of medications and allergies available
to clinicians treating you in Urgent Care, additional information (e.g.
significant history is coming soon)
• GP2GP: ensures the patient detailed record moves with the patient and
is immediately available to a patient’s new GP
• Electronic Clinical Correspondence: Letters sent directly to GP
information system: more secure, quicker, less paper.
• Electronic Prescription Service: Prescriptions sent electronically to
patient nominated pharmacy. Prescriptions can be cancelled
electronically.
Right Information,
Right Place, Right Time
Its early days….
• Shared detailed records: with patients consent, the GP
record, or part of, can be made available to professionals
treating the patient elsewhere to support integrated care.
• Electronic care plans: available to support continuity of
care in line with patient wishes.
• Patient access: already using booking and medications
ordering. From April 2015 GP Practices must offer the
facility for patients to view summary information online.
• Patient Held Records and Self Management Tools: pilots
being considered as part of Better Care programme…….
What's my role in sharing information?
Sharing requires consent
• Consent can be
Implied (opt-out) or Express (opt-in)
• Consent must be informed:
“Do you know how your information is shared and
with whom?”
• Patients should decide what to share and what not
to share, and when to share, with whom.
• Access to records for you, and your carer so you
can see what’s recorded.
• Its your CHOICE
Your Choice
Currently…
• Consent for sharing Detailed Records is different to
Summary Care Record and Care.Data.
• Opt-out to stop sharing your Summary Care Record
• Opt-out to stop information going to Care.Data
• Opt-in to share detailed information from your GP Record
• If a health care professional needs to view your GP
Record, you will be asked for permission to view.
• You can change your mind at any time by talking to your
GP surgery.
• You can restrict access to sensitive parts of your record.
Your Choice
You also have choices about:
• Using the Electronic Prescription Service.
Paper prescriptions will continue to be
available for patients who don’t nominate a
pharmacy.
• Using Online Services. These are an
option and not a replacement for face to
face services.
Sharing must be secure
• NHS Care Records Guarantee imposes a duty to:
– Maintain accurate records
– Keep records secure and confidential
– Provide information in an accessible format
• Caldicott Guardians ensure patient information is protected
and is only shared on a need to know basis
• Only staff treating you can view your information
• You can find out who has viewed your information
• Encryption and technical safeguards such as smartcards
• Mandatory training for all staff
• Professional ethics
Our Commitment
We need to ensure…
 Patients understand and choose how their information is
shared
 Information is secure and shared with those who need it
 Information is high quality
 Information is available to professionals who need it
 Information will be developed around the patient, enabling
more personalised care
 Patients will be
empowered and supported to use
information and tools.
 Information will be recorded once and shared
Records Sharing:
how can it support
High Quality Care?
Records Sharing
How can it support High Quality Care?
Scenario 1 Urgent / Unplanned Care
Summary Care Record used by Out of
Hours GP
“An elderly man who had repeatedly denied any drug allergies
was found, using the SCR, to have had such a severe
anaphylactic reaction to penicillin previously, that he had been
prescribed an Epipen – our healthcare staff were about to
give him amoxicillin (a penicillin-based antibiotic).”
Dr Simon Collins, Clinical Lead, Medway On Call Care
Records Sharing
how can it support High Quality Care?
Scenario 2 Shared Care
Shared record
• Patient with rheumatoid arthritis taking methotrexate, prescribed
by the consultant.
• The following week the patient attends their GP surgery, diagnosed
with urinary tract infection.
• Using the shared records helped the GP choose which antibiotics
to use avoiding a potentially dangerous interaction.
• The GP went on to take over shared care prescribing and
monitoring of the methotrexate.
Consultant Rheumatology Nurse Clinical Lead
Records Sharing
How does it support High Quality Care?
Scenario 3 Shared Care Plans
Co-ordinating Palliative Care
• An elderly gentleman with lung cancer was admitted to hospital when
he developed a chest infection.
• When he was discharged home, he decided he didn’t want to go into
hospital again and wanted to die at home. His preferences were added
to a shared care plan by his GP and a “Just in Case box” organised.
• During a crisis at the end, Out of Hours services were contacted. All the
services involved were able to see his preferences, and contact his
District Nursing team who enabled him to die peacefully at home.
Records Sharing
How does it support High Quality Care?
Scenario 4 Shared Care Plans
Preventing avoidable admissions
• South East Coast Ambulance use a system to enable their crews to
have up to date information about a patient's health, their care plans
and needs.
• This supports crews to make the best clinical decisions when they are
with a patient because they know what's normal for the patient, who
to contact and what the patient’s preferences usually are.
• Your district nurse can share information about your care with the
ambulance service to help in an emergency.
• You will be asked for your consent and be aware of the information
shared.
Records Sharing
How does it support High Quality Care?
Scenario 5 Patient / Carer as Care Partners
Patient Online Access to GP Records
Patients / Carers with online access say that it:
• reduces trips to the practice,
• allows them to view tests results and other important information
when needed e.g. travelling, when consulting other professionals
• supports shared decisions
“I have a chronic disease and feel a real partner in the management of my
health. Whether I am at home or abroad, I can monitor information and
share it with any other health professional involved in my care. I would be
lost without it now!”
What do you think…..
• What do you think are the benefits of sharing information about your
health?
• What do you want to know about how your information is used?
• How can we ensure people in your community know about the
choices they have to control the way their information is used?
• What are the implications and considerations for your community of
more information and health services going online?
• What support will people from your community need to make good
use of online technology and information about their health?
• What concerns do people have about their health information being
shared?