"System One"

Author
Discussion

RB CV8

Original Poster:

371 posts

206 months

Sunday 14th August 2022
quotequote all
I'd appreciate input from anyone familiar with "System One".

I am particularly interested in the protocols surrounding its use in a hospital environment, and whether it should be standard procedure to refer to the system prior to prescribing medication, specifically with regard to allergies.

I prefer not to go into too much detail at present as to why I am making such an enquiry, though if I just say that I no longer have my Dad it is probably a pretty big clue.

Many thanks.

dave_s13

13,859 posts

274 months

Sunday 14th August 2022
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I'm a SystmOne clinical advisor so pretty much clued up on the intricacies of how the whole thing works.

Feel free to pm me if you like but there is a chance of me overstepping my professional boundaries depending on what your issue might be. I think I might know given the reference to protocols.

Obviously the NHS has official routes for complaint.

RB CV8

Original Poster:

371 posts

206 months

Sunday 14th August 2022
quotequote all
Many thanks for the quick response. I shall drop you a pm, but quite understand that there is a limit to what you may be able to disclose.

gangzoom

6,649 posts

220 months

Sunday 14th August 2022
quotequote all
RB CV8 said:
I am particularly interested in the protocols surrounding its use in a hospital environment, and whether it should be standard procedure to refer to the system prior to prescribing medication, specifically with regard to allergies.
L
SystmOne has NO interoperability with any hospital EPR. There is no NHS standards on which EPR or data system should provide the 'master' patient record on medicationa or allergies.

Essentially SystmOne is a GP system only, and any governance regarding it is strictly primary care only.

Edited by gangzoom on Sunday 14th August 15:35

dave_s13

13,859 posts

274 months

Sunday 14th August 2022
quotequote all
But it has evolved over time. There are hospital units, gp units, community, mental health and secure units etc etc.

Quite correct in that they don't all integrate. I have no direct experience of hospital EPRs but I have seen and know they can be a right hotch potch of systems.

I've worked with consultants who work in outpatient and inpatient units who use a combination of SystmOne, the shared care record and other legacy systems to run their clinics. The prescribing was via SystmOne. SystmOne does feed into the shared record but doesn't integrate. It's no wonder things can go wrong.

bigpriest

1,717 posts

135 months

Sunday 14th August 2022
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No help to the OP - sorry to hear what happened and hope you get an explanation.

There are lots of combined patient records delivered in different ways across the country. There is a requirement in the latest NHS Act to deliver an integrated electronic patient record by 2023 but this won't necessarily be delivered by hospitals - hospitals will contribute patient data along with GP practices, social care, community, mental health etc. into a central record - I think the newly formed ICBs are responsible for this.

The bottom-line is that if you are in hospital there is no guarantee that a hospital doctor would have access to your GP records when considering treatment (although many do). This is obviously an issue with A&E and Emergency admissions where the patient may not be in a position to disclose any information and communication with the GP practice may not be possible.

gangzoom

6,649 posts

220 months

Sunday 14th August 2022
quotequote all
dave_s13 said:
I've worked with consultants who work in outpatient and inpatient units who use a combination of SystmOne, the shared care record and other legacy systems to run their clinics.
There is a massive difference between what a few invested inviduals do versus a blanket hospital wide policy with hard governance around it.

The OP is clearly asking about a potential medical complication issue relating to prescribing and allergies. Unless the hospital in question has a clear policy on stating the GP system allergy record is a 'master' it become very hard to comment without some very clear details about the situation, which isn't something to be on a public forum in any situation.

As far as I know even HIMSS level 7 hospitals don't need to mandate how primary care record such as allergy integrated into an EPR for prescribing purposes.

K77 CTR

1,615 posts

187 months

Sunday 14th August 2022
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Patients have to give permission for their gp records to be available too. Sometimes I look at records and can't see them because the pt hasn't consented.

RB CV8

Original Poster:

371 posts

206 months

Monday 15th August 2022
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Thanks to all for the responses. The basic reason behind my query is of course quite evident, though it is probably best not to add too many details at this point.

I will say, however, that one doctor in the hospital Dad was admitted to established that Dad had an allergy to a particular medication, and did so using SystmOne; unfortunately, that was after he'd been on it for 3 days, having been prescribed by a different doctor.

My brother informs me that when he has had cause to take either of my parents to a small local hospital in recent years, the staff have always been familiar with their long-term GP history, so presumably have a policy of using the system tools available to them.

Regrettably, Dad was in a large hospital in an adjacent county. The Coroner's Investigation is ongoing so I'd best leave it there.


gangzoom

6,649 posts

220 months

Monday 15th August 2022
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RB CV8 said:
Regrettably, Dad was in a large hospital in an adjacent county. The Coroner's Investigation is ongoing so I'd best leave it there.
I hope the coroners report will be of some help, though I suspect its little condolence in these situations.

It might make no difference to you, but certainly from my point of view the lack of data interoperability between different health care settings is unacceptable, especially when when private organisation are so good at capturing and using personal data which is of no real consequence compared to things such as allergy.

We have the IT know how to reduce/mitigate so many human factor related clinical errors, and prevent families/patients from coming to harm. But for lots of reasons, change is painfully slow on this front, however what you and your family are going through is something the NHS can/should prevent. We will get there with better data interoperability, its not an if, but when.


Edited by gangzoom on Monday 15th August 12:29

thebraketester

14,591 posts

143 months

Monday 15th August 2022
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Sorry to hear this. In this day and age things like this simple should just not happen.