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electronic Palliative Care Summary (ePCS)
Dr Peter KiehlmannGP, Aberdeen & National Clinical Lead
Palliative Care eHealth
http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/LivingandDyingWellhttp://www.ecs.scot.nhs.uk/epcs.html
Questions?
How best to roll out in your Board? Lothian Pall Care/Oncology Discharge letters Benefits to Sec Care EPS /ePCS
Meetings planned with key stakeholders Primary Care Palliative Care OOH eHealth LTCs
Living and Dying Well delivery 2010 Assessment Tools Anticipatory Care Plans Palliative Care DES ongoing Communication Training National Resuscitation Policy – DNA CPR “Public awareness Death, Dying & Bereavement”
ePCS - What is it?
An electronic Palliative Care Summary An extension to Emergency Care Summary (ECS) & Gold Standards Framework Scotland (GSFS) For use both In Hours & OOH ePCS replaces current faxed communications Allows GPs & Nurses to record in one place
Diagnosis, Rx, Pt Understanding & Wishes, Anticipatory Care Plans, review dates, lists for meetings
ePCS Overview
OOH clinician ePCS display
ePCS update 1. During
consultation
2. Due to prescription
3. Team meeting or other contact
Audit
trail
ECSStore
NHS 24
A&E
Ambulance
TBD…
Practice Admin. Staff
PracticeServer
GP /DN
consultation
ePCS Dataset Consent - Palliative care data transfer Carer details and key professionals Diagnosis – as agreed by patient by pt & GP Current Rx –Rpt, 30/7 Acute, Allergies; Patient wishes
Preferred Place of Care [PPoC] )DNA CPR decision ) Anticipatory
Patient’s & Carer’s understanding of ) Care diagnosis/prognosis ) Plan
Just in Case – Rx & equipment ) Advice for OOH care )
GP Mobile no., death expected? Cert. etc )
EMIS - Summary
ePCS no diagnosis added yet
Diagnosis agreed with pt & added
Patient/Carer Wishes
GP View – ePCS on GpassDr Brown Dalmellington
•Live document•Easily updatable•Can be filled in by any member of team•Out of hours only need notified when initially commenced.
New ECS build screenshots
Access to PCS Information
Base ePCS –view in Adastra
Mobile ePCS - Adastra
Using ePCS in practice –a continuing process
Does this pt have Palliative Care Needs?Does this pt have Palliative Care Needs? Add to Pall Care Register, Add to Pall Care Register, Once Consents to send ePCS ->OOH,Once Consents to send ePCS ->OOH,
agree Medical History, set review dateagree Medical History, set review date Once consented any new info goes automaticallyOnce consented any new info goes automatically Not expected to complete in one go!Not expected to complete in one go! Complete pt wishes and Understanding, DNA CPR, record Complete pt wishes and Understanding, DNA CPR, record
“Just in case” Rx and Equipment as appropriate“Just in case” Rx and Equipment as appropriate Regular review at PHCTRegular review at PHCT Keep updating!Keep updating!
Palliative Care DES (1 of 26!)
1. Put pt on Palliative Care Register Clinical, Pt choice, Surprise Question From Prognostic Indicator Guidance
2. Make Anticipatory Care Plan – as ePCS
3. Send OOH form/ePCS within 2w
4. When dying use LCP /locally agreed pathway
Aim- encourage anticipatory care, for all diagnoses
When will it be available?
Pilots completed Aug 09 EMIS, Vision – Grampian, Gpass – A&A, Lothian
Issues addressed included acceptability & ease of use, improving the consultation & communication, anticipatory care planning,
NHS Lothian Rollout Sep 09 Vision more user-friendly March 2010 Evaluation, national rollout early 2010 Link with Board Leads for timings
Palliative Care, eHealth,OOH
ePCS – Benefits
Natural progression from GSFS & ECS Fits into day to day work of GPs & DNs Aims to identify patients “upstream” ie last 6-12 months, not just last days/weeks Encourages Anticipatory Care Planning Prompts to remind to ask about “difficult” issues
“Just in Case”, DNA CPR, PPoC Shares critical info. on vulnerable patients at important times. OOH & Secondary Care say it transforms care Patients & carers reassured Safer, better experience
Questions?
How best to roll out in your Board? Lothian Pall Care/Oncology Discharge letters Benefits to Sec Care EPS /ePCS
Meetings planned with key stakeholders Primary Care Palliative Care OOH eHealth LTCs
Living and Dying Well delivery 2010 Assessment Tools Anticipatory Care Plans Palliative Care DES ongoing Communication Training National Resuscitation Policy – DNA CPR “Public awareness Death, Dying & Bereavement”
ePCS Overview
OOH clinician ePCS display
ePCS update 1. During
consultation
2. Due to prescription
3. Team meeting or other contact
Audit
trail
ECSStore
NHS 24
A&E
Ambulance
TBD…
Practice Admin. Staff
PracticeServer
GP /DN
consultation
