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

cheryl.way@wales.nhs.uk

Informing Healthcare

Telephone 01656 678124