When I was a GP, I regularly had to manage the care of patients and take important decisions without adequate background health information. A common situation was a patient who was new to my practice, having just moved into the area, or was perhaps staying with a family member or friend, or was a business traveller. There was also the challenge of inadequate information when treating patients who had not visited my practice for a while, but had recently had a significant hospital stay for which I had no recent discharge summary or clinic letters. In these situations, I found myself not being confident about the important medical conditions a patient had, about any allergies to medicines. It was extremely difficult to be confident about a person’s up to date medications including the doses of the drugs. This is one of the things patients find hardest to remember accurately.
In recent years there have been great investments across many countries in ICT infrastructures that connect GPs and hospitals and other care centres including pharmacies to a national network that can allow information sharing. There is also an exciting momentum towards standardising a patient summary at an international level. When I was a GP, I know this would have made a huge difference to the confidence, and the safety, of my clinical decision-making. The International Patient Summary will contain the list of clinical conditions and major health issues that a patient has, recent operative procedures, allergies, a complete medication list and some other useful background information such as recent tests and measurements like blood pressure. I know that if I’d had this kind of information at my fingertips it would have made a big difference to the quality, safety and the efficiency of my practice. I can reflect now on the time spent trying to find this background information on patients, by ringing a patient’s previous GPs or telephoning hospital secretaries. This was more challenging in my inner-city environment because many of the patients came from other countries for whom I did not have telephone or email access to their previous healthcare professionals.
However, we have to be able to trust the information we access in an online International Patient Summary. The IPS is therefore both a fantastic opportunity and a call to action for all health professionals. An integrated list of conditions will only be correct if we all take the trouble to maintain the medical summaries in our own electronic health record systems. We have to update the summary when new diagnoses are made, correct the summary when a previous suspected diagnosis has been clarified. We must add new regular medications, and we must remember to remove the ones we have discontinued. Otherwise an online aggregated summary will be a gigantic mess that maybe makes us less safe rather than more safe.
There is also likely to be the opportunity for patients to access their online IPS, carry it around in a mobile app or integrate it to their wellness and fitness apps. On certain occasions they may also to be able to help maintain it. We must partner with our patients so that they do this accurately, and help us to make sure the information is always correct and up-to-date. This would take education of patients as well as physicians on how to develop and use the international patient summary for the safe, efficient and effective care.
In the end, it is the patient who is the one connecting the dots between our health care organisations, when our own systems sometimes fail to do this.
Check out the Trillium II award ceremony for the most innovative use of the IPS and the official launch of the Global Community of Practice for the IPS, at the HIMSS & Health 2.0 European Conference Spotlight Stage on Thursday June 13, at 14:50.
President, The European Institute for Innovation through Health Data