Wandsworth GPs have agreed to stream data via EMIS Web to a summary record to be viewed at a new urgent care centre at St George’s Hospital.
Battersea GP and clinical ICT lead for Wandsworth Teaching Primary Care Trust Dr Rod Ewen said the urgent care centre is due to fully open in a couple of weeks.
GPs and nurse practitioners at the centre will be able to see a summary record for patients who are registered at one of the Wandsworth practices that have signed up to the data sharing agreement.
Patients of these practices are expected to make up about 40% of attendances. Patients must be asked for consent by a healthcare professional before they can access their record.
Dr Ewen said surrounding PCTs are also looking at creating a shared record for use at the centre, which has been set up to reduce the cost of unnecessary A&E attendances.
Wandsworth GPs already have a record sharing agreement with the hospital dermatology department, he added.
In order to provide more services in the community, one or two consultants from the hospital operate a clinic out of a GP surgery, at which they and specialist GPs can access a read-only view of the patient record.
The dermatology staff also use EMIS Web to record patient data. Dr Ewen said the data sharing agreements came out of a long consultation process involving patients.
“There’s a lot of information governance gone into making sure that not everything can be seen. Patients are really happy with what we are sharing and they can opt out at any stage.”
He added that at a meeting in June, patients were “incredibly happy” to have their information shared with other clinicians and were in fact “annoyed” that it has not been done before.
Wandsworth practices have also been asked to sign up to a data sharing agreement with the diabetes clinic at St George’s Hospital.
In a similar arrangement, consultants would have read-only access to certain information including medications, demographics and details of the patient’s four last GP visits.
Dr Ewen said about 30 out of 44 practices in Wandsworth have moved to EMIS Web and all are due to transition before the end of the year.
Around ten practices are yet to send back the paperwork to allow their patient information to be shared with the services detailed.
He also wants to see the area’s community services move on to EMIS Web, allowing the creation of a primary care shared record with full scheduling between GPs, district nurses and matrons.
“That’s really important for moving 30% of hospital activity into the community; which we need to do because of cost savings,” he explained.
Community services are currently mostly paper based, with some activity recorded in CSE Healthcare’s community system, RiO.
“What we are going to have to do is change all our care pathways because providing care in hospital is hugely expensive, inconvenient and not the best way of doing it,” Dr Ewen added.
Patients often have more than one chronic illness and are treated across multiple sites by various clinicians, so a shared patient record is essential to provide them with consistent high quality care in the community.
“We need to pull that patient journey together into a single standard that we can understand,” he said. “This is a ten-year programme that is really just starting to come to fruition to provide joined up care.”
© 2012 EHealth Media.
The issue is....helliewm 128 weeks ago
As we found with SCR opt out at The Big Opt Out most patients do not understand the implications of having their records shared unless it is spelt out to them. CFH/PCT hype etc only gives one side of the story.
Patient objections and concerns.Chris Frith 128 weeks ago
EMIS give patients the option to opt out of this with their GP and the hospital have to ask for consent at their end. Hosted data is not the property of others your GP remains the data controller.
GP & EMISNUG Chair
As a patient I object to thishelliewm 129 weeks ago
What I tell my GP is private. I would not want a Consultant having fuller access or even access toa summary screen. It would be like always knowing there was 3rd party, at anytine in the future, sitting in on my GP consultation.
Fortunately my GP uses INPS and has his own server.
If I thought this could happen if would restrict very greatly what I would discuss with my GP.
It should be up to the patient and GP togather to decide what information is relevant to go into a referral. Its not for secondary care to think it can go poking around the whole GP record or even the summary record.
My worry is GP hosted systems are becoming CFH old detailed care records. Where have these so called sealed envelopes vanished too? Off into the either?
There are getting to be way opt out for patients. There should be one opt out for patients who object to 3rd party use of their records.
Then you are in the minority-but remain in control of your recordwilliamlumb 128 weeks ago
When we consulted the population (500,000) earlier this year in Cumbria with our local record sharing project no more than 3-5 patients per practice objected (80 practices). Although any record sharing is summarised and filtered for senstive codes, all sharing can be blocked at an individual patient level with a single read code. Almost all Vision LAN sites in Cumbria share their records in exactly the same way as EMIS streaming sites (via Vision 360 streaming).
I agree entriely that only data appropriate at the point of care/referral should be shared with the patient retaining control, however electronic record sharing enables the uniform application of sensible information governance standards-difficult in the past. We are developing a suite of distinct summary views that will be made available tailored to clinical situation e.g. Palliative care, Accident & Emergency, Community Services etc. etc.
In Cumbria we are further down this road than most, with the feedback to date from patients being overwhelmingly positive and the majority of our clinicans on board. There is also something in the concept that as patients we often have conditions that require multiple agency input-so the NHS needs access to enough of the overall record to offer high quality care. Being an NHS patient has responsibilities to assist organisations in providing care - as well as rights.
GP's get a significant proportion of their income through anonymised 3rd party use of clinical information (QoF), so a blanket blocking of 3rd party data harvesting would have consequences as to the level of clinical provision.
This circle of protecting patients but enabling effective record sharing can be squared-we are doing it in Cumbria to the satisfaction of over 99.9% of our population.
Hereford 5 years agoChris Frith 129 weeks ago
Hereford GPs proposed this when contracting for the city walk in centre but it was rejected in favour of Primecare who got away with an old version of Adastra and poor continuity of care, hours wasted by GPs and their staff and more importantly patients care was compromised. We can only hope CCGs are less centrally controlled.
More details?jamesfone 129 weeks ago
While examples of successful data sharing should be promoted, when reporting on them could EHI ask the team responsible their view on the cost / benefit of their sharing solution versus the national SCR?
The solution described above provides access to a "summary record for patients" presumably from the GP record (i.e. not pulling in other sources).
I expect it would be interesting for other organisations considering data sharing to understand why this solution was deemed superior to the SCR. E.g. is it a different dataset (like the whole GP record - though in this case it doesn't sound like it) or for some other reason?
Presumably this information would be useful feedback for anyone considering how the SCR might be improved?
you see the emis summary screenNeilPaul 129 weeks ago
weve been doing this for about a year now 28 practices with our local a&e and ucc. the utilisation by the A&E is hampered by it being limited to consultants only but we have cases where its been useful and indeed another local A&E wants access.
there has been a lot of confusion as to what people see. they see what we would call the summary screen. they see active problems sigficant and minor and significant past problems. they see drugs allergies and latest values as well as last 4 contacts - but none of the text of those contacts just who they were with. its effectively the summary screen in emis web they see.
our local diabetologist has fuller access to the system (with practices permission) and can view consultations and more details.
we have one local GP who is adamant this is too much access and that the hospital should only have access to drugs and allergies and perhaps a very limited set of conditions.
my biggest problem is with the consent model being easily breakable. you tick a box to say the patient agrees. well what if they arent present or dont agree - i can tick the box anyway. a system that checks with the hsopital pas system that the paitnet is in the department and text messages the patient the next day of the access would be my preferred option.