I can say I was more that a little pleased to see the following appear this week. It shows the canny Scots have not lost their touch and with decent planning and care good things in e-health can happen really quite quickly.
http://www.ehiprimarycare.com/news/item.cfm?ID=2238
Scottish emergency care records to be electronic by 2007
02 Nov 2006
The Scottish Emergency Care Summary is to become paperless by spring 2007, according to leading members of the Scottish Clinical Information Management in Practice.
Initially launched across Scotland last summer as a hybrid system, including paper and faxes, the Emergency Care Summary has already helped make out-of-hours communications more efficient effective.
Scottish health minister Andy Kerr said of ECS: “This new shared record means that NHS staff who need it to look after you can get important information about your health, even if they can't contact your GP. Health workers will also have a more complete picture of a patient's health and medical background.”
The minister added: "In the future, all health records will be stored and linked electronically and that will bring great benefits over the old paper files kept in different places and electronic records that are not linked up."
Libby Morris, chair of SCIMP told E-Health Insider Primary Care: “Following a public information campaign about the ECS, through leaflets delivered to all 2.5 million households in the country and a further 400,000 copies of the leaflet distributed to GP practices, primary and secondary care services, we were able to successfully go-live across all 14 NHS boards.”
The ECS contains important basic information such as name, date of birth, Community Health Index (patient ID number used in Scotland), medication prescribed by a GP and any adverse reactions to prescribed medicines.
The summary currently covers 2.5m patients, using a password protection system which is protected using the "highest standards of security". NHS staff will have to ask the patient's permission before they can look at the ECS, except in the event the patient is unconscious or unable to give consent.
Morris said of the early experience of the summary record: “ECS has made life so much easier for out of hours and accident and emergency staff. They can now have access to important information on the patients’ clinical history. Doctors, nurses and receptionists in out of hours medical centres; staff at NHS 24 involved in the patients care and staff in accident and emergency departments can all view records quickly and avoid risks to patients.”
NHS Scotland spent half a million pounds on publicising the new system, giving full details of how patients could opt-out of the scheme if necessary. To date, over 5 million records have been uploaded onto the system and only 174 patients in total have opted out of the scheme.
The system makes it possible to check who has looked at the patient's ECS. Patients can ask their GP to show them the information in their own summary.
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Plans are now in place to begin the switch over to electronic records and NHS Scotland is aiming to store and link full health records electronically by 2010 – beginning implementation in spring 2007.
A Gold Standards Framework Scotland (GSFS) IT development project has been established which aims to provide electronic patient records in one place helping those with cancer and palliative care needs in particular.
Staff will be able to fill in the patient record forms using the system, which can be saved electronically and then accessed by authorised staff. These will replace current paper-based tools and be integrated into existing practice IT systems.
Ian Kerr added: “GSFS will support clinicians to do the right thing at the right time, making it easy to have the best possible information available for forward planning, team review, consistent communication and sharing critical information.”
He also said that future work on the ECS will help to ensure that there is full integration with the NHS 24 advice centre and ambulance service databases. More data will be put onto the system over time, including lab results and statistics from nurse checks.
Morris told EHI Primary Care: “Patient-clinician interaction is important. Patients should know what is going on and who knows what about them. They must give explicit consent for information to be released, and trust the clinician not to abuse details which can be sensitive.”
The ECS has been piloted by various trusts, accident and emergency units and focus groups since its initial launch in October 2005. Kerr believes that the success of its national launch is thanks to the large amount of feedback received from patients, clinicians and administration staff. “
It would appear that virtually all the key issues that could block a successful implementation including proper public consultation and communication, a sensible approach to consent and privacy, having a clear implementation strategy and system wide technology approach and keeping it simple and quick have all be undertaken. The outcome seems to be great.
Well done to all those involved! Seems to me DoHA and NEHTA could learn a few things from this exercise.
David.
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