The Oxfordshire Care Summary is a health information exchange.
It allows data that’s held in GP systems, in acute hospital systems and community systems
to be seen by users at the point of care.
The only people who can access the Oxfordshire Care Summary are clinicians, are authorised
clinicians.
We have asked all of them to contribute to an online survey, and 96% of those who got
back to us reported an increase in patient safety.
The effect that we need to try and achieve with something like the OCS, is to reintegrate
care.
So many of the problems that we see in the health service are related to failures in
communication.
If we can get that working better, then undoubtedly we’ll all be in a much safer place.
From the patients’ point of view it’s about putting something in place which in
many ways many patients expect us to have in place already.
As a result of this we are able to impact upon the care of patients in a very timely
and efficient way.
The traditional notions are rope boundaries which existed within health care are being
blurred, and rightly so.
The patients that I come across, they don’t hope that we have an aspiration that we will
be sharing their information from practice to our setting at some point in the future.
They expect that we are already doing so, and they are constantly surprised, you know,
when we might say that that’s not necessarily something that we have had in the past.
For too long really, and I think it’s partly a technological thing, we’ve been working
in silos.
Information exists in the hospital and out in primary care, but there hasn’t been the
ability to join it up.
And this is what Oxfordshire Care Summary does.
If OCS begins to build a sense that we are all dealing with one medical or clinical database,
it changes people’s attitudes to how they record information and how they use it.
The Oxfordshire Care Summary actually saves us quite a lot of time because it gives us
access to patient information which would otherwise be difficult and time consuming
to obtain.
It’s important that everyone involved in the patient’s management actually shares
information about the patient.
We all work in teams and we have to hand over to other teams at different times of the day,
so we all work together, and of course when we transfer patients to other peoples care,
we need to also transfer information about their medical problems and their management.
It’s the modern way of doing things.
The Oxfordshire Care Summary doesn’t store data, it looks into GP systems, it looks into
the John Radcliff systems, it looks into community systems and provides a view, a real time view.
Once we close that down, that data is not stored anywhere in the Oxfordshire Care Summary.
And I know from my own experience how much information is gathered and very rarely shared
with other people, and that causes huge amounts of frustration.
It lowers the quality of care and the efficiency of care and it generally threatens patient
safety.
The Oxfordshire Care Summary is about individual patient care, only clinicians with passcodes
and who have been trained to understand the governance issues are able to access it.
Only clinicians within Oxfordshire can access it, after they have had the training and they
can only access it from a limited number of computers.
And it is not about amalgamating data to improve services, so it isn’t anything remotely
connected with care.data.
So if I as a GP change a drug, the clinician seeing the patient the next week needs to
be quite clear of what has happened.
Those sorts of things save the patient time and particularly, pleasantly they make the
patient realise that we are all working together as a team.
And I think that’s almost a cultural move towards a joined up approach to healthcare.
It’s the patient who controls who accesses the data, and the organisations that may hold
that data about the patient don’t have the right to withhold information.
We had one particular patient who came into the ward with low blood sugars, with quite
a significant impact on their functioning, it wasn’t just a little bit of a low sugar,
it was quite major.
Then I go away and look at the Oxfordshire Care Summary records and I can see how often
people are picking up their medication.
I can see that this particular patient had picked up 5000 units of insulin within the
past two weeks.
And that is about, for him, many months’ supply of insulin.
What we discovered there was that he was actually giving himself completely inappropriate doses
of insulin without realising it.
By understanding a little bit more about what’s happening in terms of prescriptions, we were
able to identify a major problem with his insulin administration, and what we were able
to do is use the right drug at the right time for the right patient.
As a GP, I have confidence that my patients, if they get ill or indeed perhaps equally
importantly, if they are under the shared care of hospital specialists, like the diabetic
service they can be confident that they are going to get the right information available
to them when they need it.
The OCS allows me to check a patient’s drug history, as well as their medical history
so that I’ve got an up to date picture of what medications they are taking and if they’ve
got things like allergies to medications which is particularly important.
Sometimes patients will come in with a copy of their pharmacy record but it may be two
or three months out of date or even longer than that.
So what we can access on the OCS is bang up to date.
So we know if a drug was stopped yesterday, we would know about it.
The OCS sharing data between the different services just allows us to treat the patient
looking at the whole picture so we know all the services that are involved with this patient
and if we need to contact other services, we know who is involved.
So it just allows us to treat them holistically.
So we are taking in all aspects of their care.
Before the OCS existed, particularly patients who were referred by health professionals
such as paramedics, we would have then had to make phone calls to the GP’s at practices
requesting GP summaries to be faxed to us, so we are saving time, we are saving phone
calls, we’re saving paper, and being able to treat the patient with a good clear accurate
history.
You have the most up to date information about prescribing practices within the patient’s
own practice, you may have up to date information about choices which have been made about prescribing
in response to possibly abnormal blood results which are enormously beneficial for a patient
or for a clinician who is working in an isolated setting, often seeing a patient for the first
time but without necessarily having had any of the background information at hand.
I think it empowers clinicians because it enables them to make better decisions for
their patients at the point of care.
For patients it empowers them because for the first time in our health economy we have
information to share, we have that aspiration that those patients have been expecting, or
that belief the patients have that we have been sharing this information all along, is
now a reality.
As medical care gets more complicated and the need to try and keep people managed at
home gets more important, having access to the right information helps you make the right
decisions.
In the future, the information held in your Oxfordshire Care Summary you may have entered
yourself.
It may have come from your telehealth monitoring, it may link to your diaries so that we know
when your outpatient appointments are.
So we are hoping that in five years’ time the Oxfordshire Care Summary will be the way
we share information about everybody across Oxfordshire.
Patients are the centre of all this work and we can see that having patient access to this
care summary would give them the opportunity both to check that the information is accurate
but also to manage their own health and take a more active role and I think in many ways
that’s the real game changer, because patients at the moment sort of get the scraps from
the table but if they can be there sharing the meal if I put it like that, then we’ve
got a different story altogether.
I’m sure there’s a really good future for the sharing of accurate information for
the patients because it’s going to make a lot of difference to patient care.
Nowadays, a lot of patients have quite complex medical problems and we need to know all the
background to their treatment and management.
The future of the OCS, I think is a really bright future.
As many practices as possible, well all of them, I would suggest should sign up for the
benefits of treating the patient with clear accurate records and being able to treat them
holistically . I think, in the future it will be the platform
that allows us to deliver healthcare in a much more integrated manner.
The best healthcare is provided by a full integrated system.
The OCS is making the NHS in Oxfordshire more efficient and more safe!