Information prescriptions to be linked to electronic records

The Department of Health is this week expected to set out its vision for information prescriptions that are linked to electronic patient records and a national accredited information system based within NHS Choices.

The final report on the first 20 pilots that ran over the last year is currently with ministers and could be published this week.

It is expected to endorse IPs as a useful tool for helping to manage long term conditions and to pin point how national and local systems for managing them can be integrated.

However, its findings will also highlight concerns about the amount of time they take to dispense, with GPs and consultants in particular worried about the impact on patient consultations.

IPs were proposed in the white paper Our Health, Our Care, Our Say as a way of giving people with long term conditions personalised information about their condition.

In 2007-08 the DH recruited 20 pilots sites to provide the evidence for IPs and explore different models. They included PCTs, acute hospitals and mental health trusts.

A summary report published in August found that most pilots used an IT-based system with only four using paper-only systems to dispense IPs.

It said: “The quality of IT used varied greatly as did the sophistication and infrastructure.”

Ewan King, director of analytic studies at the Office for Public Management and director of the research study for the DH, said that IT was used to develop searchable databases and to allow health professionals or users to populate a personalised IP template – what he called an “IP generator”.

“Only one place, Heart of England NHS trust, managed the golden idea of integrating dispensing an IP with the electronic patient record,” he added. “That’s really difficult to achieve for many places because they do not have fully operational integrated systems.”

The summary report calls for a national directory of accredited information on long term conditions linked to established care pathways.

Ideally this should be accredited using the forthcoming National Information Accreditation Scheme, now being tested by NICE and others.There should also be a range of ready to use templates that can be downloaded and tailored locally.

Mr King said: “The government intends to expand NHS Choices so that it has a directory of quality accredited information – a single sophisticated database covering all the long term conditions, linked to care pathways and accessible by users and health professionals.”

The first six LTC information packages on asthma, coronary heart disease, diabetes, dementia, depression and stroke are already on the website with more in their way.

The DH has also developed an online resource pack to support local implementation.

Mr King added: “The ideal plan is to create an IP generator that links to a national database and local systems. One of the ways it could work is through a package such as EMIS or Invision or, in social care, RIO.

“We would like to work with system providers to develop an inforamtion prescription module within existing care records systems. This would create a pop up screen that links to the national database and populates with information tailored to the patient.

“This could then be printed off or emailed to the patient.”

Talks were already underway with some GP system providers, he added.