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The Individual Health Record in Wales Cheryl Way Pharmacy & Medicines Management Lead Informing Healthcare, Wales With thanks to Farzana Mohammed Medical Admissions Pharmacist, Royal Gwent Hospital. Content. What is the Individual Health record (IHR)?
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The Individual Health Record in Wales Cheryl Way Pharmacy & Medicines Management Lead Informing Healthcare, Wales With thanks to Farzana Mohammed Medical Admissions Pharmacist, Royal Gwent Hospital
Content • What is the Individual Health record (IHR)? • Evaluation in a Medical Admissions Unit • Future roll-out plans
What is the IHR? The IHR is an extract of the patient’s GP record held on a central repository. The IHR is a view only product.
What is in the IHR? • Name, address and contact details • Current problems or diagnosis , medical history • Current medication, repeat medication • Allergies or contra-indications • Test results (haematology, biochemistry, microbiology) • Examination Findings (blood pressure, ECG) • GP encounters, referrals/admissions, operations • Vaccinations/immunisations
Individual Health Record (IHR) in out-of-hours (OOH) care • Started in Gwent (SE Wales) in November 2006 • 83 of 94 GP practices share information with OOH service • Access via the Adastra system • 503,192 records available (85% of Gwent pop.) • > 1 in 7 people in Wales Next Steps • Plans for roll out across Wales approved Jan 2009 • Ceredigion/Pembrokeshire (SW Wales), December • Anglesey/Gwynedd (NW Wales)
Individual Health Record (IHR) in Unscheduled Care • Extended coverage within Gwent • Went live in the Medical Admissions Unit at the Royal Gwent Hospital in May 2008 • Access restricted to MAU staff, Including pharmacists
Why do we need it? IHI research has shown that poor communication of information at transition points is responsible for as many as 50% of all medication errors and up to 20% of adverse drug events in hospital (IHI 2004)
Security ADMISSION VIA A&E, BED MANAGEMENT Patient must be currently admitted on MAU User must be on MAU computer User needs CWS login PATIENT CONSENT VIEW LAST 10 USERS ROBUST AUDIT
Improvements • Expand access time from admission to 72hrs • Add persisting consent
Problems / Resistance • Resistance from GP practices to opt in • Secondary care clinician engagement in training Interpretation of data on IHR Navigation of system – Two folders • Quality of IHR data • No access for Pharmacy Technicians
Future Plans for Roll Out • Plans to roll-out the IHR system were approved by Health Minister Edwina Hart on 7th January 2009. • Initially, the information will be shared between local GP surgeries and local unscheduled care providers.
IHR National Update • IHC is working with GP system suppliers in Wales • Demonstrator tested products from EMIS, INPS and i-SOFT – all invited to provide a solution for IHR • INPS have been awarded an extension to contract • To deploy in GP OOH in SW Wales in December • IHC continues to work with all 3 GP system suppliers • IHR content model defines data requirements • Gwent project continues until national solution available
Further Information “When Pharmacists in MAU gained access to patients’ GP records”, Farzana Mohammed, Clinical Pharmacist, September 2009, p 370 Cheryl Way National Pharmacy and Medicines Management Lead cheryl.way@wales.nhs.uk Informing Healthcare Telephone 01656 678124