Introducing an electronic palliative care summary: patient, carer and professional perspectives

Introduction and aims The electronic Palliative Care Summary (ePCS) is being introduced throughout Scotland to provide out of hours (OOH) staff with up to date records of medications, decisions regarding treatment and health status of patients requiring palliative care. Automatic twice-daily updates of information from General Practitioner (GP) records to a central electronic repository are available to OOH services. We sought to identify key issues related to the introduction of ePCS from primary care and OOH staff, to identify facilitators and barriers to its use, to explore the experiences of patients and carers, and to make recommendations for improvements.

Methods Semi-structured interviews were carried out with a purposive sample of GPs from practices using different computing software systems; out-of-hours GPs; and patients (and/or their carer) for whom an ePCS had been completed. Interviews were digitally recorded with consent, 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 such as advance care planning. No interviewee expressed concern about loss of confidentiality. Barriers raised related mainly to the introduction of a new technology including unfamiliarity with the process, limited time and IT skills.

Conclusions The ePCS has the potential to improve patient care. Training in ePCS completion and updating should be available for all GPs and community nurses.