Friday, February 07, 2014

The Scottish Health System Seems To Be Doing Things Right Moving Incrementally And Building From A Minimalist Base. Very Smart Compared With The PCEHR!

This appeared a little while ago.

Sealed with a KIS

The team behind Scotland’s Key Information Summary won the award for ‘excellence in major healthcare IT development’ in the EHI Awards 2013 in association with CGI. Daloni Carlisle reports on a project that ran early, and without the consent rows that have bedevilled English projects.
21 January 2014
Few NHS IT projects are implemented ahead of schedule: especially when they involve sharing information across multiple providers using systems from multiple software suppliers.
Yet the Scottish Key Information Summary reached a milestone set for the end of 2014 in the summer of 2013.
Real improvements to real lives
The KIS is an electronic patient summary record created in primary care that, with the help of the patient, is shared across organisations in Scotland.
It is primarily aimed at people with long term or complex conditions, for whom sharing information about their condition, their care plan, and their wishes can help to make sure that they receive the right treatment in the right place at the right time.
Dr Libby Morris, eHealth clinical lead for NHS Lothian and a GP, explains two real situations in which the KIS has made a difference.
One involved a nursing home resident who was frequently admitted to hospital vomiting blood. She and her GP agreed that she did not want to go to hospital the next time this happened.
This was recorded in her KIS. So when the situation recurred one night, the out-of-hours doctor was able to take her wishes into account and treat her in the nursing home.
Another involved a child with a complex neurological condition who needed very specific positioning when ill to avoid compromising their airway.
Again, this was recorded in the KIS. An ambulance crew called out in an emergency was able to view these instructions on the way to the child, so they arrived fully prepared and informed.
Dr Morris says this gave the whole family great confidence; and also meant they didn’t need to explain the complex information multiple times.
On a more prosaic level, using the KIS has saved countless hours of faxing and retyping patient information, as well as providing faster access to information for clinicians.
Lots more here:
You can read about the KIS record here:

What is a Key Information Summary (KIS)?

Key Information Summary (KIS) has been designed to support patients who have complex care needs or long term conditions.
KIS allows important patient information to be shared with health care professionals in unscheduled care in the NHS 24, A&E, Scottish Ambulance Service, out of hours, hospital and pharmacy environments.
Your KIS might contain information about:
  • future care plans
  • medications
  • allergies
  • diagnoses
  • your wishes
  • carer and next of kin details.
In the future, KIS will also be used in scheduled care for patients with long-term conditions; for example, for those who regularly visit renal clinics.
The full page is here:
What is interesting is that Scotland already  has a separate, widely used and much simpler Emergency Care Record.
All the record contains is:
  • Your name
  • Your date of birth
  • The name of your GP surgery
  • An identifying number called a CHI number
    Information about any medicines prescribed by your GP surgery
  • Any bad reactions you’ve had to medicines that your GP know about.
See here:
This record is already widely used - and automatically updated by all those enrolled - which is most of the population.
Pity we did not consider an approach like this in Australia.
David.

3 comments:

Anonymous said...

Who developed the software?

Anonymous said...

It should not matter who developed the code - as long as they were technically competent. It matters more who decided (and tightly defined) the clinical problems that needed to be solved, and then explored the wide space of approaches to solving them.

Its this tight focus on knowing what they are actually trying to do, and then doing only the technically most critical bit to support that problem's needs, that distinguishes say Scotland and Wales, from the much less focussed English Summary care record.

Our own PCEHR could also have done very well if it had a clear task it wanted to solve, and done it well, rather than architecting itself to do all things, equally poorly.

Bernard Robertson-Dunn said...

IMHO, the PCEHR didn't "architect itself to do all things" - it was architected to do some things but not others. e.g. its access control is woeful and so full of holes that it is untrustworthy.

But I agree that what it did do it did poorly.