Coordinate My Care integrates care plans into Emis Web

Urgent care plans for thousands of London’s most vulnerable patients care are now just a click away for almost 1,000 of their GPs.

Plan sharing scheme Coordinate My Care will now be available to 962 of the city’s GPs from within their Emis Web systems.

This will allow GPs, along with other emergency services, to easily access, create, update and share the urgent care plans of nearly 30,000 palliative and highly vulnerable patients.

Care plans are a combination of a patient’s wishes, such as a preferred place to die or do-not-resuscitate orders, and their medical history.

There are predominantly used by very unwell patients at high risk of becoming incapacitated or requiring urgent care.

“These are all people that don’t want to have to repeat their stories, especially in an emergency,” Professor Julia Riley, clinical lead for Coordinate My Care, said. “They want the professionals to know what to do already.”

Professor Riley believes the system has the capability to help not just the most vulnerable, but all patients. “I think everybody should have an urgent care plan. Who’s to say I won’t get hit by a bus tomorrow?”

Previously in London, and still in much of the country, the effectiveness of urgent care plans has been hampered by a lack of access and timeliness, she said.

The plans could be sent and updated by fax or by relatively siloed electronic palliative care coordination systems; but their use and effectiveness has been limited by real time access.

Coordinate My Care, by contrast, has been integrated into systems used by NHS 111, out-of-hours GP services, the London Ambulance Service and, now, most London GPs.

If a GP needs to create a care plan from scratch, patient data will be also automatically pre-loaded from the patient demographics service. “It has never been done like we are doing it now in London,” Professor Riley said.

While acute services have had access to Coordinate My Care since late last year, integrating the system into Emis Web was an important step in getting GPs on-board. Previously, GPs were double handling the plan on two separate systems, eating up valuable time.

Dr Naz Jivani, a GP and chair of the Kingston clinical commissioning group, said linking the two systems was trialled in his surgery, with impressive results. “Practically speaking, it also makes it easier and quicker to do as the two systems are connected.”

Matt Sweeney, who heads partnerships and alliances at Emis Health, said it could be deeply upsetting when clinicians did not adhere to the wishes of patient or their families in urgent or end of life situations.

“This information allows health teams to make more informed decisions and improve patient care.”

Riley said the next step was to full integrate Coordinate My Care into all hospital systems, such as Cerner, and the minority of London GPs who were not using Emis Web.

In July, a pilot will be run that should allow patients to update their care plans through a mobile phone app; although still subject to their GP’s approval.

If the system continued to perform well, it could be deployed for mental health and cancer patients as well, she said.

Coordinate My Care is a NHS service established in 2012 to fill the gap between end of life and urgent care services in London, from GPs, to hospices, to paramedics.

The system, which is built on InterSystems’ information care exchange HealthShare,  is also part of wider push, in concert with NHS England and the Healthy London Partnership, to accelerate the digital innovation in health.