Introduction
Better information produces better decisions. When you visit your doctor, you trust that they possess the right knowledge and abilities to provide the best care they can for you. For the doctor, it’s part and parcel of being a ‘professional’. Doctors need to have a full, clear picture of the problem, and all the relevant information needs to be at their fingertips.
The General Medical Council (GMC) is the statutory regulatory body for all doctors in the UK. Its purpose is:
‘…to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.’ (GMC, 2013)
The GMC has just published its latest advice to doctors in a booklet called ‘Good Medical Practice’ (GMP). CSC has reviewed ‘Good Medical Practice’ and identified particular areas where Lorenzo can help doctors and hospitals comply with the ‘Good Medical Practice’. We have linked the relevant domain and paragraph in GMP to features within Lorenzo.
Domain 1: Knowledge, skills and performance
Para 1, 8 – ‘…knowledge and skills are up-to-date…’. Lorenzo can provide the ‘latest and greatest’ information available about the patient. When a doctor accesses Lorenzo, they can be confident that the information contained within it is the most recent, relevant and fullest possible. It is the single version of the truth that doctors, with a legitimate relationship to the patient, can consult.
In addition, Lorenzo can provide links to trusted knowledge bases and decision-support, such as the latest drug-drug interactions in the electronic prescribing functionality.
Para 9, 13 – Performance and monitoring. Lorenzo provides practitioner-level information about activity, which can help populate ‘logbooks’ giving an indication of the type and scope of work that the doctor undertakes. This can help with appraisal and revalidation.
Para 15 – ‘…Good standard of practice and care.’ Good record-keeping is essential for maintaining good standards of care. Lorenzo provides this in a reliable, ‘Always On’ way. No more untraceable or missing notes.
Para 16a,b,f – The electronic prescribing functionality within Lorenzo is based on best practice and exploits the most up-to-date, context-relevant, integrated drug databases. It highlights drug incompatibility with alerts and prompts.
Para 19-21 – ‘Record your work clearly, accurately and legibly’. All entries in Lorenzo are date and time-stamped automatically. Entries made by one person can’t be erased by another. Strike-through facility is available to correct erroneous entries, but a full audit trail is maintained.
Domain 2: Safety and quality
Para 23 – Report incidents. Lorenzo can be used to record critical incidents. It provides the information necessary to respond to confidential inquiries whether internal or external.
Para 25a – Prompt action. Lorenzo allows for the collection of patient-level data, which can be used to alert clinicians to respond in good time.
Domain 3: Communication, partnership and teamwork
Para 31, 32 – Communicate effectively. Involving patients in decision-making is made easier when information about them is readily and comprehensively available. The Lorenzo concept of ‘better information produces better decisions’ applies equally well to patients as it does to clinicians.
Para 35 – ‘…work collaboratively…’. As the ‘single version of the truth’, Lorenzo is the repository into which everyone contributes. Although different users can configure their ‘home pages’ to suit the way they work, once entered, information is available many times to all who have a legitimate relationship with the patient.
Para 44a, 49 – Continuity and coordination of care. When a doctor writes something in the record it is available to colleagues, 24/7, who need to know. When they read from the record they can rely on it. This is true continuity of care. The doctor can be pre-armed with the necessary information when discussing options with the patient, which makes the patient feel valued, listened to, and the centre of everyone’s attention.
Para 50, 69 – Confidentiality. Lorenzo is built to the exacting security and confidentiality standards of the NHS. Access is role-based, and only those with a legitimate relationship to the patient can access sensitive information. Audits of each and every time the record is opened are maintained to easily identify who’s accessed the record.
Domain 4: Maintaining trust
Para 61, 72 – Honest and trustworthy. Lorenzo can make the invisible visible. For example, when bedside observations are done electronically they are more reliably performed and recorded. Similarly, reports can be generated that provide individual, team and hospital-level data. This enhances openness and transparency. At the same time, the security and confidentiality of sensitive patient-identifiable data can be safeguarded.
Para 68 – Accuracy. It’s easy to access information about the patient to make sure that it is accurate. Moreover, links can be built to trusted external sources of information, for example, patient information sites.