Informing Healthcare, the Welsh NHS IT agency, has announced that it is to pilot an extension of the emergency care record, officially titled the Individual Health Record (IHR), to include use in a hospital medical admissions units.
From next week, Gwent Healthcare NHS Trust, who piloted the initial system, will test the expanded component in the local hospital’s medical admissions unit.
The announcement came as Informing Health Care confirmed it will roll out the IHR, which provides a view of much of the GP record, to cover a third of Wales by year end.
Speaking at the Healthcare Computing 2008 conference, Dr Martin Murphy, Informing Healthcare’s clinical director, told E-Health Insider: “Following the successful 18 month pilot of the IHR in Gwent, we have worked closely with the local health board and identified the benefits that hospital medical admission units could also get from the software.”
Dr Murphy added: “We have worked on this expansion for a while now with close partnership with clinicians and vendors alike.”
The improved IHR system works on three requirements controlling point of access and who can access it. It also has improved audit trail functionality.
Dr Murphy explained: “It is locked down to only the medical admissions unit and only authorised clinicians can access it. It also has enhanced auditing ability and most importantly every time the record is accessed, the clinician can see the last 10 users of that particular record, encouraging them to self-police confidentiality.”
In a wide-ranging speech to the conference, Dr Murphy and his colleagues explained the paths they are taking to roll-out the IHR.
As EHI Primary Care has previously reported, Informing Healthcare is now working with health communities in Gwynedd, Anglesey, Pembrokeshire and Ceredigion to introduce the IHR out-of-hours care, in the autumn.
These sites will not initially receive the medical admissions unit component, but will get the OOH system. Dr Murphy said: “When these sites are live, we will have reached out to 1m people in Wales – a third of our target population.”
He added: “The best thing about the successful roll-out plans is to date, we have had 100% GP buy-in from these West Wales health boards.”
The IHR has been in development by Informing Healthcare and NHS Wales for the past three years, and Dr Murphy says it has been a success, engaging with clinicians from the very beginning.
The record extracts all coded data from GP systems, except sensitive data such as sex changes or STI’s, and works on an explicit consent basis. Each time the system is used, patients must give their consent. In emergencies, the doctor can click the emergency button to signal the patient could not be asked.
Dr Murphy said: “Until now out-of-hours medical staff have not had access to patient’s health records, so they only know what the patient tells them. Yet, when a patient is unwell, it’s easy to forget important things about general health or current medications.”
Dr Ian Millington, a Swansea GP and member of the Informing Healthcare board, added: “The GP record is the most accurate record of patients medical information. To be able to share this out-of-hours is a medic’s dream come true, as you know what you are treating in exact details. It enables safe transfer of care.”
Informing Healthcare Director Gwyn Thomas said the incremental approach the agency had taken has proved worthwhile but more needs to be done in Wales.
“We need to think of how we build on this and have a health infrastructure which supports information governance across all the Welsh Assembly government… We need to build working relationships with the private sector and find a way of securing long term investment – IT is only 2% of the NHS Wales budget currently.”
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