Tuesday, 10 June 2014

Summary Care Records - Tattoo Needed?

I have an allergy – a significant one, potentially life threatening, to a drug used commonly in general anesthesia.  This was discovered during surgery as a child.  At the time I was given a small card with the name of the drug.  I don’t know where the card is now.

Fortunately I can remember the name of the drug.  Being a doctor helps.  I could tell anaesthetists about the allergy before operations, and hopefully give them enough time to find a suitable alternative.

That, of course, relies on me being in a fit state to do so.  I’d need to be conscious, need to be thinking straight, need to have a good memory.  The drug has a long name, is hard to spell and relying on family members to recall it in a stressful situation is unrealistic. 

So what are my options?  I could wear (all the time) a bracelet/necklace with the information on.  I’ve looked at the designs available and although I realise their importance I’ve always delayed ordering one.  I rarely wear a watch, and am a reluctant jewellery wearer.  I am wrong, but suspect I am not alone.  I could carry a card in my wallet, but I’m not convinced anyone would search my belongings before surgery.  Please tell me if I am wrong.

My hope, as a potential patient, is that any medication and allergies would be available to the hospital team, in real time.  I have the same concerns as many about the importance of privacy and confidentiality.  But, if we have the ability to improve safety, particularly with prescribing, we should have a duty to share.  Prescribing errors are known to be a significant issue, causing patient harm and longer hospital stays.  Yet they can be reduced.  The ability to share a Summary Care Record is here, and yet we do not yet have a culture where sharing is routine, where clinical teams routinely look for information before making treatment decisions.

An elderly patient, with an acute illness such as sepsis or a longstanding condition such as dementia, will often not be able to share medical details and allergies.  We should not be in a position where even a simple decision such as which painkiller to prescribe is made without a knowledge of potentially life-threatening allergies.  I wouldn’t want to prescribe in that situation, and wouldn’t want to have surgery without the doctor being able to access my Summary Care Record 24 hours a day. 

We are not at the point yet when I have confidence that would happen.  I'm not even sure what my own surgery's position is.  What would my anaesthetist want? 

Perhaps I ought to reconsider a tattoo….

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