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A national electronic patient summary contains the minimum patient information that is needed to help healthcare practitioners make more informed clinical decisions at the point of patient care. For example, when the patient’s clinical information is unknown to the clinician because the patient is unconscious or cannot remember the medications they are taking.
This National Standard defines the information requirements for an electronic patient summary for the purpose of unscheduled care, for example, out-of-hours and emergency care. The type of information included in the national electronic patient summary includes: demographics, health problems (diagnosis), medications, allergies, procedures and vaccinations.
The national electronic patient summary is intended to be accessed by authorised healthcare practitioners who work in emergency departments or out-of-hours care and by the patient’s usual general practitioner. Ultimately, the patient should have access to their national electronic patient summary.
HIQA’s Director of Health Information and Standards, Ms Rachel Flynn, said: “A national electronic patient summary can deliver significant benefits for patients and healthcare practitioners. It can improve patient safety considerably by providing the most accurate, relevant and up-to-date clinical information about the patient at the point of care. For example, if a patient can’t remember their allergies, a healthcare practitioner can check the electronic patient summary to make sure the medication they give the patient is safe for them to take.”
The Sláintecare Implementation Strategy published in August 2018 prioritises the implementation of summary care records to support information sharing, patient empowerment and the development of digital services.
Ms Flynn continued: “A national electronic patient summary can also benefit healthcare practitioners by enabling a more efficient way of working and quicker access to patient information. It also encourages good record keeping and improves data quality in primary care.
“The National Standard published is a key building block in the development of an Electronic Healthcare Record in Ireland and will ultimately help improve patient safety.”