GPs across Bolton have begun sharing their clinical documents with the Greater Manchester care community through the Greater Manchester Care Record (GMCR) using the Docman Share system by Advanced. Health and social care professionals can now directly view GP letters to patients within the shared record via an API integration. Direct access to GP correspondence means care professionals no longer need to phone, fax or email GP practices to access this information. This results in faster decision-making, time savings on both sides and releases time to care.
The Docman Share functionality allows GP practices in Bolton to choose which clinical letters they wish to share with health and social care professionals, such as social care, mental health, acute and community trusts, across Bolton and the wider Greater Manchester region.
GPs can select correspondence to share using criteria such as by patient, document type or keywords - for example, they can set an ‘excluded words’ list.
The GP documents are then safely and securely shared with care professionals across the region through the shared record.
Powered by Graphnet, the GMCR is one of the UK’s largest digital integrated records, amalgamating essential information for 2.8 million citizens and used by health and social care professionals for direct care across the region’s 10 localities.
Bolton is the first in the country to use this functionality from Advanced and the functionality is now being rolled out across Greater Manchester.
The Bolton project team worked with their clinical leads in the Professional Reference Group (PRG) and Information Governance Board (IG) as well as technology partners, Advanced and Graphnet, to carry out a data protection impact assessment (DPIA).
Information governance concerns were resolved and practices agreed to share all documents as a best practice approach in line with data sharing agreements and to reduce the risks of not sharing potentially important information that would inform clinical decision making.
There were also strict rules around role based access, only those professionals with specific roles would have access to clinical documents, as agreed by the PRG and IG board. This ensured confidentiality and trust that the information would be used appropriately.
To mitigate the risk of misuse, the GMCR has an auditable trail for user access and it's the organisations responsibility to report misuse and follow up investigations. Patients can opt out of sharing their information on the care record, if required.
There were also challenges around training with all training having to be provided virtually. However, the team used lessons learnt from other projects and the virtual training was well received.
Within Bolton, there is a mixture of GP systems that are being used. The largest majority of practices use EMIS and Docman has been fully rolled out to these users. Deployments are underway to roll-out the system to the remaining practices.
The Bolton project team set up a task and finish group that met fortnightly for 30 minutes to keep the project on track with the support of both Advanced and Graphnet. This led to the completion of the DPIA which was signed off by the local IG board, and the development of an exclusion list to filter letters to support the data controllers within the practice.
To ensure the project remained on track, regular communications to practices and relevant stakeholders were completed in a timely manner before, during and after going live. The system was also tested with live data to ensure it was fit for purpose.
Virtual training has also been provided to ensure that the project’s information governance policy and that best practice was followed. This included developing a frequently asked questions document and user guide.
The result of the project has seen lots of success by saving time, supporting integrated working, whilst improving decision making and patient safety.
The project has facilitated faster access to a patient’s clinical documentation due to the removal of the need to request correspondence by fax, telephone or email. Users can now access the correspondence directly within seconds, freeing up valuable time to provide care.
The new system has also made it possible to access information during out-of-hours when GP practices are shut. Previously, there was no way to access the information until the service reopened, which could add long delays over the weekend – particularly during bank holiday weekends.
On top of this, the extra context of having all information within one location allows for clinicians to have a fuller picture of a patient’s care history. This allows for decisions to be made with more confidence and leads to improved patient safety due to the greater understanding delivered.
This is all encapsulated by providing a greater integration across the Bolton area, allowing for improved communication and outcomes.
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