Transcript Patient Online Access, John Bird

Patient Online
Lessons Learned
John Bird
Implementation Lead
Wessex LMCs IT Conference
12th May 2015
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NHS Mandate 2015/16
In a digital age, it is crucial that the NHS not only operates at the limits of medical
science, but also increasingly at the forefront of new technologies. NHS England’s
objective is to achieve a significant increase in the use of technology to help
people manage their health and care. In particular, the Government expects that:
•
Everyone who wishes should now be able to get online access to their own health
records held by their GP. NHS England should promote the implementation of
electronic records in all health and care settings and should work with relevant
organisations to set national information standards to support integration;
•
Clear plans should now be in place to enable secure linking of these electronic health
and care records wherever they are held, so there is as complete a record as possible
of the care someone receives;
•
Clear plans should now be in place for those records to be able to follow individuals,
with their consent, to any part of the NHS or social care system;
•
Everyone should now be able to book GP appointments and order repeat prescriptions
online;
•
Everyone should now be able to have secure electronic communication with their GP
practice, with the option of e-consultations becoming much more widely available.
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GMS/PMS regulations 2015/16
Access to medical record online
“….A contractor must promote and offer to its registered patients, in circumstances where the medical records of
its registered patients are held on the contractor’s computerised clinical systems, the facility for any such patient
to access online all information from the patient’s medical record which is held in coded form unless:
(a) in the reasonable opinion of the contractor, access to such information would not
be in the patient’s best interests because it is likely to cause serious harm to—
(i) the patient’s physical or mental health, or
(ii) the physical or mental health of any other person;
(b) the information includes a reference to any third party who has not consented to its
disclosure; or
(c) the information in the patient’s medical record contains a free text entry and it is
not possible under the contractor’s computerised clinical systems to separate that
free text entry from other information in that medical record which is held in coded
form.”;
The requirements in sub-paragraph (2A) do not apply where—
(a) the contractor does not have access to GPSOC accredited computer systems and
software which would enable it to offer the online services described in that subparagraph
to its registered patients
Online appointment booking
…A contractor must consider whether it is necessary, in order to meet the reasonable needs of its registered patients, to take action
to increase the proportion of appointments which are available for its registered patients to book online and, if so, take such action.
Other NHS IT. GPC have committed to actively promote the use of NHS IT services and will issue joint promotional guidance and
good practice with NHS England, signalling a change in the way practices and NHS England do business on NHS IT issues.
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Hearing the concerns of and gaining
information from third parties
A guide to confidentiality in health and social care: references : Treating confidential information with respect
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What is coded information in a GP
record
Summary
information
Coded
• Demographics
• Allergies
• Current repeat
medication
• Recent Acute
Medication
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Coded
information GP
Whole GP
record
Coded
• Recently discontinued
medications
• Appointments
• Diary Entries
• Patient alerts/special notes
• Vaccinations
• Recent Test results
• Past test results
• Active problems
• Past Significant problems
• Past Minor Problems
• Values ( Height/weight…….)
• Consultation heading ( no free
text/some coded entries)
• Care Plans
• Carer Details/next of kin
Coded
• Summary page
• Read code summary
• Referral letters
• Hospital letters
• Diagnostic imaging
• Letters from third parties
Coding is used for a
purpose – audit, etc.
Not coded
• Archived paper record
• Free text entries
• Patient tasks
• Patient online access /ecommunication
• Letters
What worked for practices and ourselves
• Supplier engagement, strong relationships developed
– enabled us to get support from some suppliers for
practices in last 3 months 2014/2015
• GP system suppliers promoting the webinars
increased uptake and promoted RCGP guidance
• Guidance, tools and support in place for practices in
various ways e.g. webinars, e-learning, interactive
PDF, guidance on RCGP site
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What worked for practices and ourselves
•
•
•
•
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Clear scope i.e. summary information
Support from DCC/IL team to practices
Embedded patients in the programme
Sending information directly to practices
Peer practice managers in localities to help
colleagues to understand what is needed and ‘switch
on’
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Webinars Delivered
• Online services where to begin
• Identity verification and registration
• Access to the patient record: part 1 - getting started
with summary information
• Access to the patient record: part 2 – sharing a
detailed record
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Webinars Statistics
• Number of attendances – 1718
• Number of individuals attended one or more webinars
(each person counted once) – 1002
• Type of organisation (each organisation counted
once)
• Practices - 706
• CCGs - 17
• CSU - 10
• Other - 14
• Unknown – 65
• Total organisations represented - 812
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To Improve
• Guidance was not ready for the practices when they
needed it, resulting in some practices who wanted to start
with online services in autumn 2014, delaying until 2015
• Earlier engagement in the financial year with CCGs and
LMCs
• Additional consultation with key stakeholders on the
development of new complex guidance, on identity
verification, proxy access and coercion
• Capitalise on what has worked and learn from other areas
and share the learning
• Timely access to information and data
• Understanding motivation of stakeholders
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John Bird – Implementation Lead
Patient Online programme
Patient Online Website:
www.england.nhs.uk/pe/patient-online
Implementation Team :
John Bird - Implementation Lead - [email protected]
Amir Mehrkar - Digital Clinical Champion - [email protected]
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