the individual health record in wales cheryl way pharmacy & medicines management lead informing...
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The Individual Health Record in Wales
Cheryl WayPharmacy & Medicines Management Lead
Informing Healthcare, Wales
With thanks to Farzana MohammedMedical Admissions Pharmacist,
Royal Gwent Hospital
Content
What is the Individual Health record (IHR)?
Evaluation in a Medical Admissions Unit
Future roll-out plans
Language Lesson
ENGLISH WELSH
Department of Health (DOH) Welsh Assembly Government (WAG)
Connecting for Health (CfH) Informing Healthcare (IHC)
Summary Care Record (SCR) Individual Health Record (IHR)
What is the IHR?
The IHR is an extract of the patient’s GP record held on a central repository.
The IHR is a view only product.
What is in the IHR?
Name, address and contact details Current problems or diagnosis , medical history
Current medication, repeat medication Allergies or contra-indications
Test results (haematology, biochemistry, microbiology) Examination Findings (blood pressure, ECG)
GP encounters, referrals/admissions, operations Vaccinations/immunisations
Individual Health Record (IHR) in out-of-hours (OOH) care
Started in Gwent (SE Wales) in November 2006 83 of 94 GP practices share information with OOH
service Access via the Adastra system 503,192 records available (85% of Gwent pop.) > 1 in 7 people in WalesNext Steps Plans for roll out across Wales approved Jan 2009 Ceredigion/Pembrokeshire (SW Wales), December Anglesey/Gwynedd (NW Wales)
Individual Health Record (IHR) in Unscheduled Care
Extended coverage within Gwent Went live in the Medical Admissions Unit at the
Royal Gwent Hospital in May 2008 Access restricted to MAU staff, Including
pharmacists
Why do we need it?
IHI research has shown that poor communication of
information at transition points is responsible for as
many as 50% of all medication errors
and up to 20% of adverse drug events in hospital (IHI 2004)
Security
User needs CWS login
User must be on MAU computer
Patient must be currently admitted on MAU
ROBUST AUDIT
ADMISSION VIA A&E, BED MANAGEMENT
VIEW LAST 10 USERS PATIENT CONSENT
Medication History (last 2 years)
Number of cases where IHR is accessed
0
50
100
150
200
250
300
350
400
May June July August October November
Month
Num
ber
Access rates
Improvements
Expand access time from admission to 72hrs
Add persisting consent
User profile by user group
0
10
20
30
40
50
60
70
Nursing staff (allgrades)
Consultants Junior doctors (allgrades)
MAU WardPharmacists
Staff group
Per
cent
age
of s
taff
grou
p ac
cess
ing
IHR
May
June
July
August
October
November
User profile by user group
Sources of information for Medicines Reconcilliation in MAU Pre and Post IHR Go-Live
0
5
10
15
20
25
30
35
40
45
50
PatientRecall
PatientBrought in
Drugs
CarerConfirmed
GP ProvidedDetails
IHR usedonly
Sources of data
Num
ber
of p
atie
nts Pre go-live
Go-live
Go-live 3 months
Go-live 6 months
Telephone calls to general practice
0
50
100
150
200
250
300
Pre go-live Go-live Go live 3 months Go live 6 months
Date of collection
Num
ber
and
dura
tion
of c
alls
Number of calls
Total time spent
Problems / Resistance
Resistance from GP practices to opt in
Secondary care clinician engagement in training
Interpretation of data on IHR
Navigation of system – Two folders
Quality of IHR data
No access for Pharmacy Technicians
Video
Future Plans for Roll Out
Plans to roll-out the IHR system were approved by Health Minister Edwina Hart on 7th January 2009.
Initially, the information will be shared between local GP surgeries and local unscheduled care providers.
IHR National Update
IHC is working with GP system suppliers in Wales Demonstrator tested products from EMIS, INPS and
i-SOFT – all invited to provide a solution for IHR INPS have been awarded an extension to contract
To deploy in GP OOH in SW Wales in December
IHC continues to work with all 3 GP system suppliers
IHR content model defines data requirements Gwent project continues until national solution
available
Further Information
“When Pharmacists in MAU gained access to patients’ GP records”, Farzana Mohammed, Clinical Pharmacist, September 2009, p 370
Cheryl Way
National Pharmacy and Medicines Management Lead
Informing Healthcare
Telephone 01656 678124