title: Introducing an electronic Palliative Care Summary (ePCS) in Scotland: patient, carer and professional perspectives.
abstract: BACKGROUND
  An electronic Palliative Care Summary (ePCS) is currently being implemented throughout Scotland to provide out-of-hours (OOH) staff with up-to-date summaries of medical history, patient understanding and wishes, medications and decisions regarding treatment of patients requiring palliative care: automatic twice daily updates of information from GP records to a central electronic repository are available to OOH services.
  
  
  OBJECTIVE
  To identify key issues related to the introduction of ePCS from primary care and OOH staff, to identify facilitators and barriers to their use, to explore the experiences of patients and carers and to make recommendations for improvements.
  
  
  METHODS
  Twenty-two semi-structured interviews were carried out with a purposive sample of health professionals [practice nurses (3 interviews), GPs (12 interviews), a practice manager (1 interview) from practices using different computing software systems] and patients and/or carers (6 interviews for whom an ePCS had been completed). Interviews were digitally recorded, transcribed and analysed thematically.
  
  
  RESULTS
  Patients and carers were reassured that OOH staff were informed about their current circumstances. OOH staff considered the ePCS allowed them to be better informed in decision making and in carrying out home visits. GPs viewed the introduction of ePCSs to have benefits for in-hours structures of care including advance care planning. No interviewee expressed concern about confidentiality. Barriers raised related to the introduction of new technology including unfamiliarity with the process, limited time and information technology skills.
  
  
  CONCLUSIONS
  The ePCS has clear potential to improve patient care although several implementation issues and technical problems require to be addressed first to enable this. GPs and community nurses should identify more patients with malignant and non-malignant illnesses for completion of the ePCS.
authors.affiliation: Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZN, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Hall
authors.forename: Peter
authors.initials: P
authors.lastname: Murchie
authors.forename: Christine
authors.initials: C
authors.lastname: Campbell
authors.forename: Scott A
authors.initials: SA
authors.lastname: Murray
mesh_terms: D039602:After-Hours Care; D017028:Caregivers; D003266:Continuity of Patient Care; D004059:Diffusion of Innovation; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D033181:Information Dissemination; D008297:Male; D010166:Palliative Care; D017060:Patient Satisfaction; D036301:Qualitative Research; D012606:Scotland