Sharing electronic records - Lessons from the Emergency Care Summary in Scotland Libby Morris, Clinical e health lead Scottish Government 2nd May 2012

Key Messages –What is the Emergency care Summary? –Evaluation –Progress –Lessons learnt

What is ECS? Emergency Care Summary Patient information is extracted from GP Practice computer systems Sent to ECS store twice daily Explicit Consent to view ECS record The information is ‘Read only’ and available to Emergency Care Providers

Responses of 118 NHS24 clinicians about the value of ECS in the current care episode

Response of 118 NHS24 clinicians to the question:

Incremental steps Discussions Emergency Care Summary Palliative Care Summary Key Information Summary Aims to replace paper based faxing of “Special Notes” from GP Practices Better than ‘the whole record’ Structured information and summary box

ePCS electronic Palliative Care Summary MacMillan Cancer Nurses and Marie Curie led initiative Contains significant and sensitive information –Resuscitation Status, Preferred Place of Care –Carer Details and Advice for OOH

Feedback Larger special notes free text box Smaller special notes free text box Consent rules clearer User requests –All on one data entry screen –Message when sent –Copy of report filed in record –Messages to user when expired –Must fit in with other business processes

Key Information Summary Contains: –Diagnosis and Problems –Contact / Carer details –Anticipatory Care details Information only sent with patient consent (in line with Palliative Care Summary) Where possible, information is already captured in GP Systems

2009 Dumfries and Galloway

Miscellaneous ClinicalHistory Notifications & Legals Investigations & Results Patient Banner ( Demographics as CUI standard)_ Social & Personal Alerts & Risks HealthcareEncounters Admin & Patient Preferences Correspondence Medications & Devices Clinical Notes Observations Notifications & Legal All records 3 rd Party Documents ….Links to other applications…. Services Involved in care Next of kin Carer Details OOH attendances Demographics & Contacts CHI Adverse events

On opening record warning appears to alert clinician

Patient with KIS note, KIS summary, ePCS and ECS

Summary ECS developed in Scotland for 100% Palliative Care Summary(PCS) gave important feedback Key Information Summary (KIS) will add more information and include ‘medication prescribed elsewhere’ Agreed standards are key for sharing Access for meds reconciliation Further development continues

Lessons Learned… Incremental approach works for Scotland Cooperation and compromise Joint approach with E, W and NI It’s a concept, not a ‘thing’ Keep it simple…. Shared records are difficult but… Not impossible!