title: The Scottish Emergency Care Summary--an evaluation of a national shared record system aiming to improve patient care: technology report.
abstract: BACKGROUND
  In Scotland, out-of-hours calls are all triaged by the National Health Service emergency service (NHS24) but the clinicians receiving calls have no direct access to patient records.
  
  
  OBJECTIVE
  To improve the safety of patient care in unscheduled consultations when the usual primary care record is not available.
  
  
  METHODS
  The Emergency Care Summary (ECS) is a record system offering controlled access to medication and adverse reactions details for nearly every person registered with a general practice in Scotland. It holds a secure central copy of these parts of the general practitioner (GP) practice record and is updated automatically twice daily. It is accessible under specified unplanned clinical circumstances by clinicians working in out-of-hours organisations, NHS24 and accident and emergency departments if they have consent from the patient and a current legitimate relationship for that patient's care.
  
  
  CONCLUSIONS
  We describe the design of the security model, management of data quality, deployment, costs and clinical benefits of the ECS over four years nationwide in Scotland, to inform the debate on the safe and effective sharing of health data in other nations.
  
  
  RESULTS
  Forms were emailed to 300 NHS24 clinicians and 81% of the 113 respondents said that the ECS was helpful or very helpful and felt that it changed their clinical management in 20% of cases.
  
  
  CONCLUSIONS
  The ECS is acceptable to patients and helpful for clinicians and is used routinely for unscheduled care when normal medical records are unavailable. Benefits include more efficient assessment and reduced drug interaction, adverse reaction and duplicate prescribing.
authors: libby.morris@nhs.net
authors: Libby M M
authors: LM
authors: Morris
authors: Colin
authors: C
authors: Brown
authors: Marysia
authors: M
authors: Williamson
authors: Jeremy C
authors: JC
authors: Wyatt
mesh_terms: D039602:After-Hours Care / Q000379:methods*; D001291:Attitude of Health Personnel; D016494:Computer Security; D003266:Continuity of Patient Care / Q000458:organization & administration*; D057286:Electronic Health Records; D004632:Emergency Medical Services / Q000379:methods*; D058005:General Practitioners; D006801:Humans; D059065:Medication Reconciliation / Q000379:methods; D012606:Scotland; D013222:State Medicine / Q000458:organization & administration