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electronic Palliative Care Summary (ePCS)

electronic Palliative Care Summary (ePCS). Dr Peter Kiehlmann GP, Aberdeen & National Clinical Lead Palliative Care eHealth peter.kiehlmann@scotland.gsi.gov.uk http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/LivingandDyingWell http://www.ecs.scot.nhs.uk/epcs.html. Questions?.

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electronic Palliative Care Summary (ePCS)

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  1. electronic Palliative Care Summary (ePCS) Dr Peter Kiehlmann GP, Aberdeen & National Clinical Lead Palliative Care eHealth peter.kiehlmann@scotland.gsi.gov.uk http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/LivingandDyingWell http://www.ecs.scot.nhs.uk/epcs.html

  2. Questions? How best to roll out in your Board? Lothian Pall Care/Oncology Discharge letters Benefits to Sec Care EPS /ePCS Meetings planned with key stakeholders Primary Care Palliative Care OOH eHealth LTCs Living and Dying Well delivery 2010 Assessment Tools Anticipatory Care Plans Palliative Care DES ongoing Communication Training National Resuscitation Policy – DNA CPR “Public awareness Death, Dying & Bereavement”

  3. ePCS - What is it? An electronic Palliative Care Summary • An extension to Emergency Care Summary (ECS) & • Gold Standards Framework Scotland (GSFS) • For use both In Hours & OOH • ePCS replaces current faxed communications • Allows GPs & Nurses to record in one place Diagnosis, Rx, Pt Understanding & Wishes, Anticipatory Care Plans, review dates, lists for meetings

  4. NHS 24 OOH clinician ePCS display A&E ePCS update Ambulance ECSStore 1. During consultation 2. Due to prescription 3. Team meeting or other contact Practice Admin. Staff Audit trail TBD… ePCS Overview GP /DN consultation

  5. ePCS Dataset • Consent - Palliative care data transfer • Carer details and key professionals • Diagnosis – as agreed by patient by pt & GP • Current Rx –Rpt, 30/7 Acute, Allergies; • Patient wishes • Preferred Place of Care [PPoC] ) • DNA CPR decision ) Anticipatory • Patient’s & Carer’s understanding of ) Care diagnosis/prognosis ) Plan • Just in Case – Rx & equipment ) • Advice for OOH care ) • GP Mobile no., death expected? Cert. etc )

  6. EMIS - Summary

  7. ePCS no diagnosis added yet

  8. Diagnosis agreed with pt & added

  9. Patient/Carer Wishes

  10. GP View – ePCS on GpassDr Brown Dalmellington • Live document • Easily updatable • Can be filled in by any member of team • Out of hours only need notified when initially commenced.

  11. New ECS build screenshots Access to PCS Information

  12. Base ePCS –view in Adastra

  13. Mobile ePCS - Adastra

  14. Using ePCS in practice –a continuing process Does this pt have Palliative Care Needs? Add to Pall Care Register, Once Consents to send ePCS ->OOH, agree Medical History, set review date Once consented any new info goes automatically Not expected to complete in one go! Complete pt wishes and Understanding, DNA CPR, record “Just in case” Rx and Equipment as appropriate Regular review at PHCT Keep updating!

  15. Palliative Care DES (1 of 26!) 1. Put pt on Palliative Care Register • Clinical, Pt choice, Surprise Question • From Prognostic Indicator Guidance 2. Make Anticipatory Care Plan – as ePCS 3. Send OOH form/ePCS within 2w 4. When dying use LCP /locally agreed pathway Aim- encourage anticipatory care, for all diagnoses

  16. When will it be available? • Pilots completed Aug 09 • EMIS, Vision – Grampian, Gpass – A&A, Lothian • Issues addressed included • acceptability & ease of use, • improving the consultation & communication, • anticipatory care planning, • NHS Lothian Rollout Sep 09 • Vision more user-friendly March 2010 • Evaluation, national rollout early 2010 • Link with Board Leads for timings • Palliative Care, eHealth,OOH

  17. ePCS – Benefits • Natural progression from GSFS & ECS • Fits into day to day work of GPs & DNs • Aims to identify patients “upstream” ie last 6-12 months, not just last days/weeks • Encourages Anticipatory Care Planning • Prompts to remind to ask about “difficult” issues • “Just in Case”, DNA CPR, PPoC • Shares critical info. on vulnerable patients at important times. • OOH & Secondary Care say it transforms care • Patients & carers reassured • Safer, better experience

  18. Questions? How best to roll out in your Board? Lothian Pall Care/Oncology Discharge letters Benefits to Sec Care EPS /ePCS Meetings planned with key stakeholders Primary Care Palliative Care OOH eHealth LTCs Living and Dying Well delivery 2010 Assessment Tools Anticipatory Care Plans Palliative Care DES ongoing Communication Training National Resuscitation Policy – DNA CPR “Public awareness Death, Dying & Bereavement”

  19. NHS 24 OOH clinician ePCS display A&E ePCS update Ambulance ECSStore 1. During consultation 2. Due to prescription 3. Team meeting or other contact Practice Admin. Staff Audit trail TBD… ePCS Overview GP /DN consultation

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