Dr Libby Morris

The Emergency Care Summary

Dr Ian Kerr

The Emergency Care Summary

NMAHP Meeting 6th March 2007

Dr Ian Kerr

SCI gatewayreferrals

SCI store

Lab results

SCI DC

Diabetes network

GP SYSTEMSEMIS 45INPS 55

GPASS 850ISOFT 35

ASCRIBE 15

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

OOH clinician

ECS summary request & displayECS

update

1. During consultation

2. Due to prescription

3. Other Patient contact

Who saw who for practice?

ECSSyste

m

NHS 24

A&E

Ambulance

TBD…

Practice Admin. Staff

PracticeServer

GP consultation

PRACTICE

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 36 29 157 745

Glasgow - - 209 231

Grampian 17 7 161 186

Highland 280 245 409 413Lanarkshire 277 227 558 427

Lothian - - 22 853Orkney - - 4 3

Shetland 1 0 1 0Tayside - - 69 1289

Western Isles 28 24 31 25NHS24 - - 2813 2521Totals 3329 2959 7898 10456

Total Number of Patients 4956535Patients 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 detailsLibby.morris@nhs.net