The new models of care in Scotland introduce collaborative care and multidisciplinary teams. A more extensive range of healthcare professionals will assess and treat patients. For safe and effective care, the whole team must use one set of electronic medical records.
Primary care pressures
The RCGP says: "With general practice carrying out 90 per cent of patient contacts in the health service, it is the bedrock of the NHS". We acknowledge that GP workload is a significant challenge. Patient demand is increasing for several reasons:
- we are living longer
- more of us live with at least one long-term condition
- patient expectations are higher than ever before
At the same time, it is difficult to recruit and retain GPs, leading to a national shortage of GPs, compounding the pressure on primary care.
Across the UK there are high profile programmes in place to transform the NHS. New healthcare services will create an NHS that can cope with future demand.
The new Scottish contract
The 2018 Scottish General Medical Services (GMS) Contract transforms primary care services. New models of care will reduce GP workload, giving them time to be expert medical generalists.
Health and Social Care Partnerships and NHS boards will provide extra primary care staff. These people will work in GP-led multidisciplinary teams. They will work alongside GPs and practice staff to reduce workload and improve care. The multidisciplinary teams will focus on specific services including:
- treatment and care in the community
- urgent care
These services are moving out of GP practices. Patients will go to local treatment rooms or care hubs for these services, not their GP practice.
Sharing medical records
The healthcare professionals working in these hubs will see patients from many practices. How will they know about their patients' current medical situation and background?
Effective healthcare teams need trust, respect, and collaboration. Healthcare professionals assume complementary roles and work together. You share responsibility for planning and delivering patient care.
To provide high-quality care, you need a thorough understanding of your patients. That's easy when a GP sees one of their registered patients. However, what about the healthcare professionals working in treatment rooms and hubs? How will they know about patients' diagnoses, medications and allergies?
Sharing patient records amongst multidisciplinary team members is the answer. When you have sight of your patients' medical records, you will know about their:
- previous encounters
You will be able to make appropriate care decisions, straight away and with confidence.
Feeding back to the patient's GP
It's also important to tell the patient's GP about the care that takes place away from the practice. Nurses and physiotherapists should record details of the care they provide and feed it back to the GP. This information might include:
- the nature of conversations had with patients
- the extent of examinations
- details of treatment and care
- clinical reasoning for decisions made
Vision’s patient record sharing is allowing community nurses in the rural village of Letham to improve care for local patients. Access to healthcare services has improved, the utilisation of the nurse-led clinic has quadrupled, and the community nurses’ caseload has halved. Read the case study for the full story.
What is record sharing?
It's standard practice for each care service to maintain its own set of medical records. These islands of data don't sit well with collaborative working. Open streams of communication and information sharing are essential for effective collaboration. Our advice is to use one set of records across the entire multidisciplinary team to enable the new models of care.
Primary care records are the most complete and detailed account of our medical histories. Record sharing gives other healthcare professionals access to these electronic records. It must be:
There are valid reasons for consolidating systems, but sharing patient data is not one of them. The NHS is massive. It's the fifth biggest employer in the world. It's inconceivable to think that the whole of the NHS could use one system. Service providers need their specialist systems to support the care they provide. Record sharing is essential.
Sharing with Vision
You use Vision 360 to share the medical records stored in GPs' Vision systems. Its core is a central data hub that keeps copies of patient data from participating GP practices. In the background, it streams details of patient encounters as they take place into the hub. We host Vision 360 on the N3 network, so it's safe and secure.
Clinicians and carers working outside of the GP practice can access the Vision 360 data. They can add information too, which Vision 360 makes available to the patient's GP.
Vision Anywhere is an innovative app that provides 24/7 access to patient records on the device of your choice. We launched Vision Anywhere so GPs could access records during home visits. It has since evolved into a full consulting solution to use with shared patient records.
There are apps for all popular devices:
- iPhone and iPad
- Android phones and tablets
- Windows tablets, laptops and convertibles
We'd recommend that nurses and physiotherapists should use an iPad or Windows laptop during their episodes of care.
Always share everything?
Our medical records are sensitive and personal. How do you make sure you're only sharing what you need to, and only with the people who need to see it? Does every healthcare professional need to see the whole patient record?
The answer is no. Each clinician and carer needs access to the information that's relevant to the care they'll provide. That will vary between services. A nurse might need to see diagnoses, medications and allergies. However, a physiotherapist will only need information about a specific episode of care.
The secret is only to share what each service needs. Is that possible? It is when you use sharing agreements. They are at the core of Vision's patient record sharing. Putting sharing agreements in place is much easier than you might think:
- The local team of GPs specify which parts of the patient record to share with care services. As an example, this could include the summary and current medication, but nothing else.
- The next step is to specify particular conditions and medication to share or exclude. Eliminating sensitive information such as data about sexual health is normal.
- The final decision is to define who can access the information. Individual role-based user accounts are set up for these people.
- We link the sharing requirements and user accounts to control and govern the patient record sharing for each service.
The beauty of sharing agreements is that you can set up as many as you want within the same locality. Running agreements side-by-side controls precisely what each service can access without compromising security.
Vision 360 offers centralised appointments as well as record sharing. You can create appointment books for anyone on your team. Other team members can check their availability and book appointments. These centralised appointments are ideal for physiotherapists working in treatment rooms or hubs:
- staff at all practices serviced by the physiotherapists can view availability
- GPs, nurses or receptionists can book physio appointments at any time
- physiotherapists do not need to get involved in appointment admin
Our goal is to remove unnecessary clutter from software, so it's easy to learn and use. This attention to the user experience is evident in Vision 360's Smart Search, which makes it easy to find a patient's details to book their appointment. Vision 360 will locate the patient without having to know their registered practice.
Communication and tasks
Sharing patient records and appointments are essential aspects of collaboration in healthcare. Effective teamwork is also dependent on open and transparent communication.
We are putting the final touches on our brand new task management software. It will allow anyone in your multidisciplinary team to create, allocate and track tasks. You can chat about tasks to clarify details and ask questions too. Subscribe to our email updates, and we'll let you know when Vision Tasks is available.
On Tuesday the 24th of July at 1.00 pm, we're hosting a webinar to show you how easy it is to share records and appointments. You'll see how record sharing underpins Scotland's new GMS contract. At the end of the webinar, you'll have an opportunity to ask us your questions too. Register now to listen live. If you can’t make it, you can still register and watch the recording afterwards.
In the meantime, get in touch if you have any specific questions or would like to talk to us in more detail.