Transcript Power Point Presentation

Key Information Summary (KIS)
NHS Borders
Webex Presentation
22 May 2013
Agenda
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Overview and Aims
What is in a KIS?
Consent Model
Link to GP Contract
EMIS Screenshots
Experience and Feedback – Forth
Valley
• Who can access KIS?
• Timescales and National Rollout
• Further Information
KIS Overview
• Aims to replace paper based faxing of “Special
Notes” from GP Practices
• More generic version of ePCS
• Support for:
– Anticipatory Care Plans (ACP)
– Long Term Conditions
• Utilise existing ECS infrastructure and process
• eHealth Strategy and Quality Strategy
deliverable by 2014 – all patients where
appropriate to do so to be offered a KIS
What is in a KIS?
• All ECS and ePCS information
automatically included
• Medication changes to include:
– Single Dose / Frequency field
– Medication Prescribed elsewhere detail
– CMS Dispensed Date
• Triggers and reminders for expiry of
information
• Consent to share information
4 Sections on KIS Form
• Section 1 – “Special Note”
– Free text field of 2048 Characters
– Expiry Date
– Patient and Carer details including all
agencies involved in care
– Other demographics (Next of Kin)
• Section 2 – Current Situation
– Medical Information and Diagnosis
– ACP / Self Management Plan agreement
– Home Oxygen
4 Sections on KIS Form
• Section 3 – Care and Support details
– Homecare support
– Incapacity / Guardianship
– Power of Attorney
• Section 4 – Resuscitation
– DNACPR
– CYPADM (Children Resuscitation)
– Current and Preferred Place of Care
KIS Consent Model
• Clinical decision to send KIS is made by GP
• Patient to be asked for consent to share
information by GP
– Different from ECS model
– KIS is “Opt In”, ECS is “Opt Out”
• If patient unable to give consent then this is to
be clearly recorded
– Dementia patient
– Patient who is a risk to others
• Emphasis is on sharing information if
appropriate to do so
GP Contract
• New GP Contract in Scotland has QoF points
available for Anticipatory Care Plans (ACP)
– 0.75% of patients in each practice in 2013/14 to have
ACP in place
– 1.5% of patients in each practice in 2014/15 to have
ACP in place
• Suggested that patients with SPARRA score
of 20% - 60% are selected first for ACP
• ACP’s to be shared using KIS
• Guidance on SPARRA / ACP and KIS
published by Scottish Government
KIS Overview
• Emphasis on “Summary”
• Only information appropriate to share will be
available
• Only complete the fields you need to
• KIS record can be “built up” over time
• Sections are pre-populated as much as
possible
• Read codes used as often as possible
• Current feedback is that KIS takes about 5
minutes to fill in
• KIS can be printed and shared with carers
EMIS Screenshots
• About to start national rollout as part of
Release B
• SUBJECT TO CHANGE
• Provided as an overview and to show
layout of KIS
• Further changes and improvements
planned for Release E and F in 2013
• Training Guide UG190 available from
EMIS
Feedback from NHS Forth Valley
• All 56 GP practices have used KIS
through EMIS as part of pilot
• Over 1000 patients have now had a KIS
created
• Feedback provided via formal evaluation
and PLT session
• Further evaluation ongoing
Feedback from NHS Forth Valley
• Time taken to complete KIS as part of ACP
process varies from 2 minutes to 20 minutes
– Depends on complexity of patient needs
• Most GP’s reported minimal impact on
workload
• Positive feedback on layout and overall
process
• Minimal requests for further information from
patients
What GPs liked
Excellent for
sharing info
with relevant
others
Good breadth
of
information
Structured,
concise and
easy to fill in
Ability to add
descriptive
text
Easy to use
and navigate
Much better
designed than
ePCS
What GPs disliked
Would like to
see slightly
fewer tabs
Unable to import
significant past
problems
(e.g. MI 1990)
Entering carer
information is
not easy
Delays to pilot
starting and
delays to wider
implementation
Feedback from patients
Very happy to
share this
information with
relevant others
Gives
confidence when
GP surgery
closed
Excellent
idea
Would not want
some sensitive
information from
medical notes
shared with others
No problem
as long as
information is
‘secure’
Surprised that
this was not
happening
already
End Users in Acute Hospital
Good that it is
not just for
palliative care
Information is
clear and
concise
Anticipatory care
information
particularly useful
Would be good if
we could also
write to KIS
rather than readonly
Some of the
KISs in pilot
were of limited
quality
This information
could
dramatically
improve the care
we provide
Who can access KIS?
• Any user of ECS will have access to KIS
• This includes:
– NHS24
– OOH
– A+E Departments
– Scottish Ambulance Service
– Hospices
– Hospital Pharmacy
• Rollout extending to include:
– Other Secondary Care Departments
– Community Nursing (through MIDIS)
End user screenshot of KIS – A+E
Timescales and National Rollout
• EMIS Release B Rollout complete
– All EMIS practices switched on for KIS
automatically
• Updated version of KIS / EMIS to be released in
September 2013 and November 2013
– Release E and Release F
• National Release for Vision in May 2013
currently in pilot
Further Information
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KIS website: www.ecs.scot.nhs.uk/kis
KIS Blog: www.keyinformationsummary.org.uk
EMIS User Guide UG190 available from EMIS
Vision User Guide and information
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http://www.inpshelp.co.uk/pilot/Emergency%20Care%20Summary/index.htm
• Patient Information from NHS24:
• http://www.nhs24.com/Explained/MyInfoNHS24/WhatisKIS
• http://www.commtacs.co.uk/nhs24/kis/draftclip.html (BSL Video)
Questions?
[email protected]
0131 275 7557
Adastra Screenshots
• Provided as an overview and to show how
KIS will appear in Out of Hours
• Important to note that Special Note field
appears separately from KIS tab
• Alerts currently available in A+A and will
be rolled out to all boards soon
On
opening
OLC
warning
appears
to alert
clinician –
only if
SPN, KIS
or ePCS
End user screenshot of KIS – Adastra
End user screenshot of KIS – Adastra (Special Note)