Real-Time Digital Medicine
Dr Amir Hannan
Full-time General Practitioner (www.htmc.co.uk)
Information Management & Technology clinical lead, NHS Tameside & Glossop
Primary Care IT lead, NHS North-West (www.northwest.nhs.uk)
Map of Medicine clinical lead, NHS North-West
Member of the HealthSpace Reference Panel, NHS Connecting for Health (www.healthspace.nhs.uk)
Member of the Clinical Leaders Network (www.cln.nhs.uk)
[email protected] taken from www.mediclicks.net
Addenbrookes Hospital
Cambridge
17th February 2009
Summary Addenbrookes Access to Health Records
Why did I start sharing records with my patients?
The “best” PHR /EMR in the world….
Partnership of Trust
Paradigm Shift in Healthcare
Building the next generation healthcare system
How do we enable patients to access their records
www.htmc.co.uk
What can patients see?
What are patients doing with access to their health records
Time for YOU to get access to YOUR health records
•Shipman murdered his patients.•Fictitious “diseases” added to patient notes after they had died.•Thought to have used morphine which he collected in other people’s names.•Ramifications felt throughout the world!
Why ?•Sit down protest in the surgery•No IT system•Patients to see•Job to do…
Rebuilding TRUST in me and the Medical Profession
The “best” Personal Health Record / Electronic Medical Records in the
world….
…is about to get better…
Partnership of Trust
The Paradigm Shift in Healthcare
IT based health care system
Internet
Increase in health literacy
Patient access to Electronic Health Record
Patient choice
Choice leads to better outcomes
But there are concernsIn general, the first reaction is anxiety, worry and avoidance
Patients seeing our muddles, red herrings, poor typing, inappropriate phrasing
Patients seeing 3rd party info that they should not see
Patients seeing something that would cause them serious harm
It will increase litigation against us
We don’t have time to promote records access and do all the other things we have to do
Patients will take longer boring on about minor irrelevancies in the record
Patients will come more often, worried well
Patients won’t understand what we write
Clinicians will have to change the way we write
We will not be able to speculate about diagnoses any more: this pt may have MS, wait+see
Who’s helping us? PATIENTS General Medical Council The Medical Defence Organisations Information Commissioner’s Office EMIS / PAERS Department of Health NHS Connecting for Health National Information Governance Board Local Care Record Development Board NHS Tameside & Glossop NHS North-West (formerly known as NW SHA) Local Medical Committee Self Help Groups Patients and the Public International Council for Medical & Care Compunetics (www.icmcc.org) Primary Healthcare Specialist Group, British Computer Society Map of Medicine MPs Patients know best (of course!)Etc etc etc
So let’s build a system that supports
clinicians, patients and the system!
Supports Summary Care Record
SupportsHealthSpace
Supports Google Health / HealthVault
Supports patients and GPs
Let’s have a blended approach
Why does Records Access matter?
Record access complements and enhances most of the processes of care
Research suggests that full record access: is safe, is popular with patients (wouldn’t you like to have access whenever and
wherever you were?) improves patient confidence in themselves and their clinicians, enables patients to improve the accuracy of their records, improves the efficiency of consultations probably improves preventative and self-care.
Record access is also recommended as it: Improves communication with patients Supports copying letters to patients complies with the Data Protection Act is recommended for patient safety improves the process of obtaining informed consent is necessary for information governance
So how do we do it?
Are you eMPOWERed yet ?e
Medical
Patient and the Public
cOmmunication
World wide web
Electronic
Record
Feature List for Patients
Feature List for Clinicians / Staff
Haughton Thornley Medical Centreswww.htmc.co.uk
Haughton Thornley Medical Centreswww.htmc.co.uk
Haughton Thornley Medical Centreswww.htmc.co.uk
Haughton Thornley Medical Centreswww.htmc.co.uk
Haughton Thornley Medical Centreswww.htmc.co.uk
Haughton Thornley Medical Centreswww.htmc.co.uk
Haughton Thornley Medical Centreswww.htmc.co.uk
Haughton Thornley Medical Centreswww.htmc.co.uk
Using HealthSpace
Using HealthSpace
Map of Medicine via NHS Choices
Map of Medicine via NHS Choices
Haughton Thornley Medical Centreswww.htmc.co.uk
Haughton Thornley Medical Centreswww.htmc.co.uk
Haughton Thornley Medical Centreswww.htmc.co.uk
What do patients see?
Patient access to GP record
Patient Access to GP record
Book appointment online
Patients or their families
can order repeat
prescriptions on-line
Can easily see what
patients are taking and not taking
Blue i button gives further information directly from the repeat
script explaining what the
medication is for
Up-to-date repeat
prescriptions
Order Repeat Medication
Information re Aspirin
Information re Aspirin
Information re Aspirin
Information re Aspirin
Ordering repeat prescriptions
Access GP record
GP record - Summary screen
GP record - Summary Screen
GP record - Summary screen
GP record - Summary screen
Consultations
Links to diabetes
Foot care for diabetes
Results
Information re blood tests
Letters
Pictures
Medication
Real-time Digital Medicine from a patient perspective
Patients CAN and ARE making a
difference
Benefits beyond compliance and concordance being felt
Dear Amir,
I am currently carrying out a records management audit at the PCT. On my travels around the PCT, the Fracture Liaison and Osteoporosis Nurse was telling me about patients from your practice who when attending to see the nurse were bringing copies of their records and reports that they had accessed from home. The nurse was very grateful as this helped in the treatment and tests that were undertaken and saved her a lot of time and also occasionally gave information that meant that either a re-scan was not undertaken again or was not necessary and therefore this prevented unnecessary appointments. I said I would pass on the positive comments to you.
Regards Rob Anker
Records Manager
Tameside and Glossop PCT
The Map of Medicine in the Real World
for patients with access to their records
“thought the web site was very good and was easy to use. It made me think about my illness and different things that my doctor could have or should have done to help my condition. It made me feel as if my doctor could have done more than just give me anti depressants. It will be good for more illnesses to be added. I think websites like this one has helped me manage my illness better” (patient with full access to GP electronic health record)
“I've had a look at the website and thought it very good. Some of the terminology may be a little difficult for some people especially if you have been recently diagnosed and don't know the jargon” (patient with full access to GP electronic health record)
“I had a quick look at the glaucoma one. Content very good and well summarized but not suitable for patients at all. I think only the most well informed / literate patient will be able to make sense of the information and way it is presented.” (patient with access full access to GP electronic health record and works as a consultant ophthalmologist)
“I accessed that informative site. It was very clear, and about the best information I have had up to now. I would imagine, though, for people of a less hardy disposition, it would prove to be a bit frightening, to see the facts put so boldly before them. Again, there is no alternative for persons like myself taking a more holistic route to combat this disease, and with that in mind, there appears no hope. The last option on the list is adjuvant therapy. To face the fact that this disease is now "incurable" can be daunting. But if you look at it from another angle, so is asthma, diabetes and arthritis. It’s how you look at a problem and interpret it.” (patient with breast cancer with metastatic disease and who has full access to GP electronic health record)
“I found the site very interesting easy to use, also easy to understand as well. I did find my condition and found that I have had all that the experts have said, have experience all that” (patient with full access to GP electronic health record)
These are NOT just a handful of patients
These are NOT just a handful of patients
We have over 600 patients over 3 years now having access to their records in our practice alone
Young, old, English, Foreign, rich, poor, IT-savvy, not so IT-savvy – very few exceptions
Not a single problem
40 practices offering the same service around the country with more than 60% enabled to do so (all EMIS practices)
Complements the Summary Care Record by NHS Connecting for Health
Patients wondering why everybody else is not doing it!
www.htmc.co.uk has been built so that it can be deployed in another practice, across a PBC or PCT. 95% of the information is as relevant to patients in Cambridge as it is to my patients in Hyde! We are now linking to local Providers too!
ConclusioneMPOWERed patients need access to their medical records AND high quality information about their care AND how to manage it.
www.htmc.co.uk is a platform that enables you to do this
e
Medical
Patient and the Public
cOmmunication
World wide web
Electronic
Record
Isn’t it time YOU got access to YOUR records and started using it to improve YOUR health and
enter the world of REAL-TIME DIGITAL MEDICINE ?Dr A Hannan
for the latest information and to sign up for my blog please see
www.htmc.co.uk
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