Embed Size (px)
Citation preview
Emergency Care Summary
DunblaneNovember hb2008
NHS in Scotland
• 14 Health Boards– Primary and
Secondary Care• 1030 Practices
– GPASS, InPS, EMIS, Ascribe
• 1 National Ambulance Board
• Scottish Government Health Department
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
Progress to Date
• ECS Service pilot started in 2004• National ECS launched in Sept 2006• 98.5% of Scottish GP Practices
connected• Full Integration and rollout:
– NHS24– OOH
• ECS available in A+E for 12 out of 14 Health Boards
• National Cross Border Access across all Health Boards in Scotland
Progress to Date
• Over 5.2 Million Patient Records extracted
• 1400 patients have ‘opted out’ of practices connected– Represents 0.02% of all
patients• Over 1.5 million accesses to date
and increasing trend in use• Expected increase in use as new
developments are available
Users of ECS
• Over 5000 registered users (not including GP, Administrators or Audit)
• Access controlled through Local System Administrators in each Health Board
• System to system integration in place for:– Adastra and Taycare OOH– NHS24– A+E Integration due in 2008
• Web access for Audit– A+E, OOH Admin, System admin (per NHS
Board)
Consent Model
• Implicit consent to extract / send the data– Regular extract and update of
information• Explicit Consent to view ECS record• Patients can Opt Out / In at any time
– Simple flag on GP Practice System• ECS information is read only• Only available to Emergency Care
Clinicians
ECS Security and Audit• Access and security controls with
passwords and log on for all clinicians • Patients must give permission for the
clinician to view their records• Practices can check who has accessed
their patients’ records• Audit controls in place for:
– Practice Reporting– Health Board Audit– Cross Border Audit– National Audit
ECS Security and Audit
• National Audit checks include:– Unsuccessful log in attempts– Casual Browsing / suspicious
behaviour– Long periods worked (trap sharing of
passwords)– Check on practice files structure
– National Access Protocols– Refresh of training information for
Local System Administrators
ECS Access Report
Palliative Care Summary
• Macmillan Nurses led initiative• Palliative Care Forms
– Based on Gold Standards Framework Scotland (GSFS)
– Paper process already in place in many GP Practices
– IT Development to assist with key patient group
GSFS Solution
• Extension to ECS dataset to include more detailed information to send to OOH for Palliative Care patients (known as PCS)
• Move from paper to electronic information• Reduction in faxes from GP Practices to
OOH Centres
• Consent Model•ECS – Implied to send, Explicit to view•PCS – Explicit to send, Implied to view
Future Developments
• Integration with National A+E System• Scottish Ambulance Service• Preparation of Business Case
– Patient Access– Extension of Users– Extension of Data Set
• NO DEVELOPMENT WITHOUT CONSULTATION
Future Developments
– Patient Access– Extension of UsersOther hospital departmentsDentistsCommunity pharmacists
Future Developments
– Extension of Data Set
ImmunisationsSpecial notesPast medical historyRecent Consultations
Summary
• Good progress with use of ECS• Security built in with fully integrated
solutions• Audit at all levels with focus on inter
Health Board Access• Palliative Care Summary next
development• Consultation and communications in
planning for next stage
