Sunday, February 15, 2015

Here Is The Proof That Starting Simple And Evolving Can Really Work In Health IT.

This report appeared a few days ago.

SCR reaches 50m patients

9 February 2015   Sam Sachdeva
The NHS Summary Care Record has reached the 50 million patient mark, with more than 30,000 record views now occurring each week.
The milestone is the latest demonstration of the SCR’s growing use, after it was initially bedevilled with criticisms about confidentiality and low viewing levels.
The Health and Social Care Information Centre announced last week that there are now 50 million people with an SCR created from their GP records, meaning that 90% of the population is now covered.
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.
In July 2013, it was expanded to include patients’ end-of-life care information, immunisations, and significant past problems and procedures.
Richard Jefferson, NHS England’s head of business systems, told EHI News the milestone is a demonstration of the “significant benefits” that the SCR is delivering to clinicians and patients across the country.
“The fact that over 50 million records are now available means it should be business as usual for clinicians to have access and utilise this critical source of care information.”
Jefferson said there has been a rapid growth in viewing levels across urgent care settings in the last year, with over 30,000 views a week.
“With both CQC and Monitor identifying the sharing of care information as expected best practice, we expect this positive trend to continue.”
The HSCIC said the SCR programme will be working with GP systems suppliers in 2015 to expand the capabilities of the record.
Lots more here with a link to some commentary:
The NHS Summary Care Record (SCR) is the UK version of the PCEHR with a few differences.
The differences are:
1. It takes advantage of the fact that patients are enrolled in practices, have a NHS number (a HPI equivalent) and virtually all GP Practices are automated.
2. The system is not patient controlled and is automatically created - but it is possible to opt out, although pretty much no one does.
3. GP Systems in the UK upload an updated SCR (which is a very basic record) whenever the doctor updates the patient record - and the summary replaces the earlier one. There is no attempt to display historical data - just the current data that might actually be useful.
4. The record holds the minimum amount of data for facilitate emergency care, which is the intent of the record  and which is where the record is accessed - A&E Departments.
5. GP practices are the information and history holders and the centralised system is just used to provide access to a current system to help in acute presentations.
So simple, useful and evolving beats complicated, over specified and no clear purpose.
Now the system is having 30,000 accesses a week it will be interesting to see if some benefits arising from the system can be identified.
Maybe we could update the PCEHR to do something useful like this and actually have it work with simplicity etc.?


Terry Hannan said...

David, I am in agreement with your appraisal of this NHS project howevere there appears to be some discrepancy in the numbers presented. A Dec 2013 comment by Rebecca Todd tha is hyperlinked to the link you provided highlights the following aspects.
"While creation of the records surged ahead, use of them by clinicians had been lagging behind.[A concerning finding similar to our PCEHR].
However, the update reports that 428 sites now have viewing capability and the number of records being viewed has risen to an all-time high of 12,000 a week. This figure is more than three times higher than it was at the start of the year.[This figure is less than that cited in the article in the first part of your blog.]
Acute hospital pharmacy staff are the most avid viewers, but the records are also being used in urgent care, minor injury units, walk-in centres, out of hours, NHS 111 and prisons.[A positive sign]
An evaluation conducted over 12 weekends by pharmacists at the medical admissions unit at North Tyneside General Hospital found that of 480 new patients who were assessed, the SCR was used in 146 instances.
Of these instances, more than 60% resulted in an intervention that was a direct result of having access to the SCR [A more extensive study on these interventions will be interesting reading.

Dr David More MB PhD FACHI said...


The article is 14 months newer than the one you mention, and it looks like adoption is accelerating to almost complete. I think that explains a lot of what you mention.