Primary care information improves specialist care
The care of patients using diabetes and endocrinology services in Cheshire and Hertfordshire is being improved through the integration of healthcare organisations, using EMIS Web.
In Liverpool, specialist care is being delivered in a local setting thanks to information sharing across organisational boundaries, using the same software.
Better diabetes and endocrinology services in Cheshire
Diabetes and endocrinology specialists in Cheshire are now able to access a summary of the patient’s primary care record, enabling them to make more informed decisions at the point of care and helping them to advise a far greater number of patients.
Two GP practices in Nantwich and Middlewich, covering approximately 10% of patients in Central and Eastern Cheshire Primary Care Trust, are streaming information from their EMIS LV systems into EMIS Web.
The system gives diabetes and endocrinology specialists at Leighton Hospital in Crewe and Victoria Infirmary in Northwich access to a primary care summary record that includes information about medication, allergies and previous diagnoses.
After logging in and searching for a patient, the clinicians – who include doctors, consultants, registrars, a dietician and specialist nurses – can see the record as a 'read-only' view. Consent is given by the patient in hospital and audited in the system.
Dr Adrian Heald, consultant physician at Leighton Hospital’s diabetes and endocrinology clinics, explains: “Accessing primary care information affords us a different perspective on the patient’s condition and the way we manage chronic diseases, giving us important extra information about patient care at the GP end.
“Having a fuller picture of the patient’s health, we are able to produce a more focused health management plan, tailored for each patient.”
The next phase of the project will allow hospital clinicians to record details from a consultation into a clinical record template that will be added to the patient’s record in real-time. The patient’s GP will be able to view this back at their practice.
More than 80% of practices in the PCT use EMIS systems but to achieve greater interoperability, EMIS is working with InPractice Systems (INPS) to facilitate the streaming of patient data from their GP systems into EMIS Web.
It is hoped that the shared record solution will soon become available to other specialist clinics and to the provider arms of the PCT.
Dr Heald continues: “In addition to enhancing the quality of the individual patient experience, there is potential for adapting the search and report facility in EMIS Web to take a longitudinal view of trends in management of cohorts of patients.
“This could result in major changes to care pathways, for example in relation to determining the most effective pharmacotherapeutic strategies. We have received very positive feedback from patients, as they recognise the value of sharing information to improve health services and health outcomes.”
In a similar project, diabetes clinics at two branches of the West Hertfordshire Hospitals NHS Trust – Hemel Hempstead Hospital and St Albans Hospital – will also be able to view a summary of the patient’s primary care details.
Manor Street Surgery is leading the project, which involves two other practices at the pilot stage, and which also involves streaming patient record data from EMIS LV into EMIS Web.
Dr Elizabeth Ponsonby, a GP at Manor Street Surgery, says: “A clear display of historical data is crucial for managing diabetes, so for clinicians to have access to more complete patient information is a huge step forward.”
As in Cheshire, the project is being phased. The first phase allows clinicians to view the summary information. The next phase is for clinicians to be able to record into a consultation template. The patient gives implied consent at the referral stage, and an audit trail is recorded.
The vision for the future is for diabetes clinics to be brought out of hospitals and into the community –making it even more essential for clinicians to be able to access information, wherever they are located. EMIS and the trust are also working with INPS to extend interoperability to non-EMIS practices.
Specialist referral clinics in Liverpool
Liverpool Primary Care Trust has developed a 'new health service for Liverpool' strategy, in which patients will be treated outside hospital if appropriate.
To support the strategy, EMIS Web is giving clinicians working for the providers of three services – joint injection, anti-coagulant checks and minor surgery clinics – access to a summary of the patient’s primary care record.
As with the diabetes projects, details including medication, allergies and previous diagnoses can be viewed, improving consultation efficiency and continuity of care.
Any alerts are also highlighted and a summary of the patient’s last blood pressure, height and weight are displayed. Before the provider can access the patient’s information, verbal explicit informed consent must be given.
Patients in one of the PCT’s four consortia (Matchworks) are able to visit one of nine joint injection providers, run by GP practices.
Two sites are offering anti-coagulant checks, run by a secondary care nurse at a practice so patients no longer have to visit the Royal Liverpool Hospital. Patient satisfaction with this service is extremely high, with feedback from one patient stating: “This scheme has changed my life.”
Twelve practices will offer minor surgery to every practice in the PCT. The programme, commissioned by primary care, is being rolled out, with two sites live currently. GPs refer patients into this service electronically, directly from EMIS LV and PCS into EMIS Web.
For each service, a template enables clinicians to record consultation notes, which can be viewed by the patient’s registered GP. Dr Simon Bowers, joint injection provider and Information Management & Technology lead for Liverpool PCT, says: “EMIS Web enables access to information in a format that is easy to use.
“It has helped to standardise the quality of referrals and we can now give patients the convenience of being able to choose a provider for the services.”
Links
Liverpool Primary Care Trust: a new health service for Liverpool
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