Hampshire Health Record Toby Cave HHR Programme manager

HHR overview Acute provider Acute provider HHR Path & Radiology Pathology ordering EDS & Clinic letters HHRA CCG Community health Community health Referral letters GP Practice GP Practice Social Care Referral letters Path & Radiology EDS & Clinic letters Summary Coded information

GP feeds - signed up by year 77% signed up Jan 2012

Clinical staff use

Reducing repeat x-rays and pathology tests Avoid contraindicative drugs, eg antibiotics GP found to be resistant Avoiding admissions Saving time gathering information Case study: –Patient discharge to a care home with TTA Warfarin; registers with a new GP –New GP visits, but has no access to notes or discharge summary. Patient fails to mention on warfarin –HHR check indicates Warfarin, GP orders urgent INR –Patient has INR > 8, patient managed to recovery Feedback from clinical staff

Information accessed – staff roles

Patient access – why & what No decision about me, without me Changes / updates Booking appointments Repeat prescriptions Updating demographics Consent / sign up Information sharing Clinical trials SMS / reminders Access to records Complete / interpreted Mental health / sensitive Two way comms Patient assessments Contacting clinicians SUS / Billing

Patient access - How Via GP systems 75% of NHS patient contact with GP But not complete acute or community record Direct access to the HHR Covers most providers No booking of appointments or updating demographics Via 3 rd party eg Microsoft Health vault Unproven – Googlehealth Requires wide provider buy-in

Patient access - Challenges User accounts Citizen identification and account administration Separate usernames and passwords 2 factor authentication Sharing access: Parent / guardian / carer access Record management Full vs summary record Interpretation of records Clinician checking of records – nothing to harm the patient or ID third party

Patient publicity Approach: Existing channels of communications General public PPSA GP registration letter includes paragraph on the HHR Regular adverts in Hampshire Now, City view and Flagship leaflets via Health checks campaign 6000 leaflets distributed through the local authority 2000 Patient links news letters include HHR leaflet 1500 Leaflets distributed around SUHT Point of care communications Leaflets and posters sent to all GPs for waiting areas GP newsletters, message boards, check in screens, prescriptions At the point of access, patients are informed about the HHR