As the Department of Health push for pharmacists to become more clinically-focused, can read-only access to summary care records (SCR) go any part of the way towards enabling the sector to take those steps?
We caught up with superintendent pharmacist Stewart Kelly, who has had access to SCR for 18 months, to hear his experience of the benefits and the ‘incredible’ limitations of being able to see patient data.
Q: What have been the benefits of having access to SCR?
Kelly: The benefits materialised really quickly. Within a couple of days we had a patient call with a query because they had been given two lots of antibiotics and didn’t know which one to take. The GP surgery was closed and they had heard had nothing from the surgery at all.
I was keen to use SCR and keen to find out what was going on so I checked that the patient’s record and they had been prescribed a penicillin that they were allergic to. Subsequently they were prescribed something they were not allergic to but they had not been told to definitely not take the penicillin.
So from a safety point of view, it was invaluable because it could have been disastrous for that patient.
Would you say previously you would have been forced to make a blind judgement call in that situation?
Absolutely, and that’s how community pharmacies worked for a long, long time.
Patients still come in, and we’re quite lucky because we do have SCR, but patients still come in to pharmacies and assume that our computers are all connected to the GPs and the hospital, they assume we get all of the information that’s available.
Have you experienced any particular frustrations with SCR so far?
The only real major drawback is the integration, if it was integrated into the PMR system it would be seamless and you could just use it in the same way I use System One when I work in the GP surgery.
The Department of Health has made it clear it wants pharmacists to become more clinically-focused, does SCR access enable that progression?
At the moment it is incredibly limited because we don’t have write access. It does help, but for instance when I work I with System One, anybody that accesses it can write onto the patient records and that actually becomes part of the patients contemporaneous medication record, we don’t have that.
So to be able to do things like childhood vaccinations or flu vaccinations we have to use a stand-alone system and what would be incredibly brilliant is if we could just write it onto the patient’s medication records and say this is what we’ve done and this is what we have given.
But also if we give any advice to patients or tell them to do anything at the moment we have to rely on an ability to be able to send paperwork to the GP and on the patient to tell the GP.
If we could just write that onto their medical record then that would be so much easier, but until the write access comes it’s going to be very difficult to do that.
Do you think write access is on the horizon?
I do anticipate that that will eventually arrive; it just adds a whole other level of bureaucracy and legislature to go through to ensure that patients are happy and also GPs who are the guardians of these patient records are happy because the GPs do see them as their records and not necessarily the patient’s records.
But if we’re going to take on this mantle of being this overarching healthcare professional on the high street and deliver these services and deliver the kind of interventions that certainly our professional body and our regulatory body say we should be doing then we’re going to have to have the ability to be able to do that and convey that information to all the people that need to know it.
We are not interconnected and until that happens it’s very difficult for us to move anything forward at any great pace.
Has access to SCR allowed you to prompt discussions with GPs that you otherwise would not have been able to have?
Absolutely, for instance we had a patient with newly prescribed clopidogrel interaction with omeprazole, she was not one of our patients but she bought the clopidogrel to us.
I can look at that and I can see that there’s an interaction there and can suggest an alternative, it allows me to go back to the GP and say actually ‘do you really want me to do this there are better alternatives’ and that information we just wouldn’t ever have had before.
Previously you had to rely on the patient’s ability to tell you the information or rely on them to bring in a complete list of medication on their repeat ordering slip, if they don’t have that you’re working blind, you’re working with half the information.
Do you think community pharmacists should be encouraged by the SCR roll-out?
I think they should be absolutely encouraged by it, I think they should grab the bull by the horns.
I can understand some reticence because with increased information comes an increased level of responsibility but if we’re going to ever move away from the current pharmacy contract that we’ve to a service-based pharmacy then this has to be the first step and I think we need to grab that and we have to run with it.