Emergency Care Summary
             Libby Morris
   Chair of ECS Programme Board
    General Practitioner Scotland
Agenda

  • Emergency Care Summary
    • Dataset
    • System Overview
    • Usage
  • Palliative Care Summary
  • Evaluat...
Overview

 • Patient Safety is key driver
 • Read only record extracted twice daily from
   GP Practice Systems
 • Integra...
Agreed Dataset
• Patient demographics (address, telephone, CHI
  number)
• Allergies and Adverse Reactions to medications
...
System Overview

PRACTICE                                               NHS
GP                     OOH                    ...
Usage

  • Pilot in 2004, National Rollout in 2006
  • Over 5.4 Million Patient Records extracted
  • 1600 patients have „...
Total Accesses to ECS
2009 Dumfries and Galloway
Palliative Care Summary (ePCS)

 • Moving from paper based forms to shared electronic
   information
 • National rollout a...
New Developments - SAS

 • ECS use to be piloted by Scottish Ambulance
   Service (SAS)
 • Rollout to Paramedic “in-cab” s...
EHR Impact Evaluation

• Formal evaluation carried out by EHR Impact
  Programme
• Focus on Social and Economic benefits
•...
7.000.000


    6.000.000


    5.000.000


    4.000.000
₤
    3.000.000


    2.000.000


    1.000.000


           0
 ...
Clinicians Views

• Improves patient care by making decisions safer
• Many people have no idea what medication they are
  ...
Clinicians Quotes

• “One of the best tools we have got for improving patient
  safety”
• “ECS has been a godsend, I can‟t...
Lessons Learned…

 • Incremental approach works for Scotland
 • Careful consideration of patient groups and
   clinical ne...
Questions?
 • Jonathan Cameron (jcameron2@nhs.net)
    • Programme Manager


 • Dr Libby Morris (libby.morris@nhs.net)
   ...
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Emergency Care Summary

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Emergency Care Summary. Morris L. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

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Emergency Care Summary

  1. 1. Emergency Care Summary Libby Morris Chair of ECS Programme Board General Practitioner Scotland
  2. 2. Agenda • Emergency Care Summary • Dataset • System Overview • Usage • Palliative Care Summary • Evaluations and Clinical Feedback • Future Direction and Challenges
  3. 3. Overview • Patient Safety is key driver • Read only record extracted twice daily from GP Practice Systems • Integration with Out of Hours and Emergency (A+E) Departments • One national store for all of Scotland • Explicit Consent to view ECS record
  4. 4. Agreed Dataset • Patient demographics (address, telephone, CHI number) • Allergies and Adverse Reactions to medications • Medication history - Repeat prescriptions in past 12 months - Acute prescriptions in past 30 days • Consent Flag • Patient opt out status
  5. 5. System Overview PRACTICE NHS GP OOH 24 consultation clinician ECS summary ECS update request & A&E display ECS System Ambulance 1. During consultation Practice Admin. Who saw Staff who2. Due to prescription for practice? Patient contact 3. Other TBD…
  6. 6. Usage • Pilot in 2004, National Rollout in 2006 • Over 5.4 Million Patient Records extracted • 1600 patients have „opted out‟ of practices connected • Represents 0.03% of all patients • Over 4.7 million accesses and increasing trend in use • 2.1 million accesses in 2009
  7. 7. Total Accesses to ECS
  8. 8. 2009 Dumfries and Galloway
  9. 9. Palliative Care Summary (ePCS) • Moving from paper based forms to shared electronic information • National rollout across Scotland • Integration with patient pathway at critical stage • Contains significant and sensitive information • Resuscitation Status • Preferred Place of Care and Patient Wishes • Diagnosis and Current Treatment • Carer Details and Advice for OOH
  10. 10. New Developments - SAS • ECS use to be piloted by Scottish Ambulance Service (SAS) • Rollout to Paramedic “in-cab” systems • Fully integrated with clinical reporting • Consent will be given by patients • Pilot underway…. • National rollout following pilot • Focus on clinical benefit • Performance review
  11. 11. EHR Impact Evaluation • Formal evaluation carried out by EHR Impact Programme • Focus on Social and Economic benefits • Extensive review of all stages of ECS project • Quality, risk reduction and efficiency savings • Not cash saving! • Benefits can be expressed in financial terms • Initial findings presented at WoHIT Conference in Nov 2008 • Final report published Dec 2009
  12. 12. 7.000.000 6.000.000 5.000.000 4.000.000 ₤ 3.000.000 2.000.000 1.000.000 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 Present value of total annual costs Present value of annual benefits
  13. 13. Clinicians Views • Improves patient care by making decisions safer • Many people have no idea what medication they are taking • Especially in an emergency when they are ill and confused • At least 50% of details given by patients is wrong or has something missing when checked against ECS • Local evaluations have found that: • Clinical decisions can be more timely, accurate and patient centred • Pharmacists are using ECS as the key tool for medicines reconciliation
  14. 14. Clinicians Quotes • “One of the best tools we have got for improving patient safety” • “ECS has been a godsend, I can‟t imagine how we managed without it” • “It can take ages if we need to phone GP surgery” • “ECS information can help the most vulnerable patients, especially those who are admitted over the weekend who have no one to bring in their meds” • “Before ECS we often had to „work blind‟ with no information at all”
  15. 15. Lessons Learned… • Incremental approach works for Scotland • Careful consideration of patient groups and clinical need • Evidence emerging of clinical benefits • Integration is more than just technology • Must build ECS into main clinical system • Keep it simple….
  16. 16. Questions? • Jonathan Cameron (jcameron2@nhs.net) • Programme Manager • Dr Libby Morris (libby.morris@nhs.net) • National Clinical Lead
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