Wednesday, July 09, 2014

If Managed Well It Looks Like The Opt-Out Approach For Shared Electronic Record Can Work.

This appeared a little while ago.

SCR reaches 40m patients

2 July 2014   Sam Sachdeva
The NHS Summary Care Record has hit the 40m patient mark, just over a year after low usage rates led to calls for it to be scrapped.
NHS England says it is “delighted” by the milestone, and is now focussing on rolling out the SCR in A&E, NHS 111, and GP out-of-hours services.
The SCR was one of the key projects of the National Programme for IT in the NHS.
It was intended to create the 'national' element of an integrated care records service that was otherwise to be delivered by the roll-out of detailed care record systems at trusts.
The SCR was eventually given the go-head by the present government on an opt-out basis.
The record provides a core set of required clinical data, including allergies, medications and adverse reactions, pulled from GP systems, which can be viewed by health professionals involved in a patient’s care.
While the 40m mark is a significant milestone, usage rates for the SCR have been a concern throughout its history.
Figures released in February last year revealed that while there were more than 22m records in existence at the time, they had been viewed just 240,000 times.
This led to some calls for the programme to be scrapped. However, by the end of the year, NHS England was reporting that SCR usage rates among clinicians had risen to an all-time high of 12,000 views a week.
The HSCIC told EHI that the SCR now gets 19,000 views a week and that the number continues to grow.
GP practices will be required to provide an automated upload of their summary information to the SCR, or have published plans in place to achieve this, by 31 March 2015.
Full article is here:
What we have had here is a gradual approach with proven infrastructure and a decision to keep the shared record as simple as possible - so it met the desired purpose of providing basic key information when it was needed in emergency rooms etc.
It has eventually worked, I believe, because it has not fallen into the trap of excess complexity and detail which added very little value and which made the system unwieldy. Pity those driving the PCEHR did not follow a similar approach. What was happening in the UK was well known well before the PCEHR was designed. Technical overreach is how I would describe what DoH and NEHTA were guilty of!


Anonymous said...

Yes, easy to look back, but PCEHR would be working if it just focussed initially on delvering a small useful subset of readily available and needed data, e.g. Discharge summaries from hospitals.
Next steps could then be GP summaries, current medications and allergies (one source not multiple conflicting sources).

One of the biggest mistakes was to load up all the silly claims data from Medicare into an otherwide empty record. So much time and money wasted on this useless and confusing information, which when taken out of contex developed 'errors' and lack of confidence in the system from consumers and clinicians.

Now much harder to get it working and being used.

It will make a great universit/project management study example of what can go wrong.

Bernard Robertson-Dunn said...

"It will make a great university/ project management study example of what can go wrong."

Not really. IMHO, it went wrong for all the same reasons many other large scale information system projects go wrong. Too much focus on the technology, not enough on the problem and the data. And they were told this in comments to the ConOp; so they can't claim they weren't warned.

It will just join the long list of failed projects the lessons from which are not learned by senior managers in both the public and private sectors. It can be encapsulated in one word - hubris. That's the real tragedy.