Pharmacy teams use pharmacy patient medication record (PMR) systems to store medicines-related information, and these systems are being developed to support new, clinically-focused pharmacy services. However, a number of national electronic health record (EHR) services are now available to provide medicines-related patient information.
The England Summary Care Record (SCR) is a national electronic patient record in England, created from data extracted from detailed GP records. SCRs have now been created for over 55 million people in England.
The core SCR dataset contains information about a patient’s medication, allergies and any previous adverse reactions to medicines. Additional information might be included, with the patient’s consent, such as significant medical history, reason for medication, immunisations, care plans (for example, anticipatory care information) and patient wishes/preferences (for example, concerning end of life care).
The SCR has been found to be useful with medicines reconciliation on hospital admission - ensuring that medicines prescribed on admission correspond to those that the patient was taking prior to admission. Because the SCR reduces the time spent finding medicines information (i.e. contacting GPs by phone), medicines reconciliation is more likely to take place within 24 hours of admission, in line with National Institute of Health and Care Excellence (NICE) guidance.
Since 2015, the SCR has been rolled out for use in community pharmacies in England. SCR is used in community pharmacies in the following scenarios: a) to check allergies, b) to check current medicines for out-of-area patients when making emergency supplies, c) to check eligibility for services such as flu vaccination.
More than 96% of the population of England now have a SCR, and community pharmacists are being incentivised to access the SCR with quality payments as part of the pharmacy contract.
In Scotland, the Emergency Care Summary (ECS) is viewable by staff at out of hours centres, A&E departments, some wards and also by NHS 24 staff. Pharmacists have been able to gain access to ECS information through direct contact on a professional line to NHS 24 and through locality portals. The ECS contains patient details, GP surgery details, allergies and ADRs and prescribing history.
As with other national NHS electronic records in Great Britain, patient consent is required every time the record is accessed. Patients may opt out of the scheme by contacting their GP surgery.
In Wales, the Welsh General Practice Record (WGPR) is a national summary of key information created from the GP record, and is used to support unscheduled care. It contains patient details, details of current GP practice, a record of current and recent medication, medical problems from GP consultations, recorded allergies and results of any recent tests.
As with the English SCR, patients need to give consent to allow a health professional to access their record, and there is an opt-out system for patients who do not want to have a WGPR.
In England, Local Health & Care Records (LHCRs) are being introduced to enable safe and secure sharing of a patient’s health and care information as they move between different parts of the local NHS and social care system. The PRSB has developed an information standard for the core content of LHCRs – see below.
Benefits of the use of electronic health records (EHRs) include:
- Patient safety – prescribing is more accurate and prescribing errors are reduced due to more information being available at the point of prescribing.
- Service efficiencies – reduces the time taken by pharmacy staff to check medication information with GP surgeries, and may reduce time taken for medicines reconciliation on hospital admission by up to 50%.
- More effective care – enables medicines information to be accessed out of hours or at weekends, and patient queries to be resolved without referring them back to the GP.
RPS has produced general guidance on the use of EHRs.
See EHR Guidance Update March 2016