Electronic Patient Records (EPR), Library Services (LS) and Multidisciplinary Team (MDT) Meetings: Is It Not Time to Integrate Primary Care for the Better?

Key Points: What This Work Adds

• 1.

  There is now a need for GPs to enter dialogue with and social services, to prompt tighter integrated services in primary care.

• 2.

  Electronic Patient Records (EPR) need to be supplemented by decision support, personalised care planning and self-management education from trained health professionals, as well as social support from family, friends and peers.

• 3.

  There needs to be a neutral environment where patients and health professionals can come together to provide more awareness of EPR in addition a neutral environment where patients and the public can source additional literature and context.

• 4.

  Patient-Centred Multi-Disciplinary Team (MDT) meetings will allow patient and carers to gain more EPR awareness and a tighter understanding of what their results actually mean.

• 5.

  GPs should look to pilot and implement rotation-based patient-centred MDT meetings in library environment, where one GP from a practice can rotate and call upon colleagues from primary and secondary care sectors to meet at library location where a patient is also called in for review. This should be at least piloted for patients with an LTC since they might have a number of co-morbidities and who might require further support with respect to EPR, HL and online support who would otherwise not know how to use facilities. A rotation system would allow more time for GPs to spend with patients in primary care.

• 6.

  Health Literacy (HL) is predominantly a skills-based construct that does not include motivational elements. Using modes to improve HL alone to determine the needs of patients and simplifying instructions for them as a result may be a barrier to that person, thus affecting patient and professional relationship.

• 7.

  There is an on-going need to support and work in partnership to increase awareness of local services in health and social care.

Introduction

Patients with Long-Term Conditions (LTCs) account for around 50% of General Practitioner (GP) appointments, 64% of outpatient appointments and 70% of hospital bed days (Department of Health 2012). Around 70% of total health and care expenditure in England is attributed to people with Long-Term Conditions (LTCs) (Department of Health 2012). People diagnosed with an LTC are perhaps the most rigorous consumers of health and social care (Barnett et al. 2012).

Between 2010 and 2030, it is postulated that the number of younger adults with disabilities (aged 18–64) will increase by 32.2% from around 220,000 to around 290,000, and the number of younger adults with physical or sensory impairment by 7.5% from almost 2,900,000 to 3,100,000 (Snell et al. 2011).

In relating, coping too has an impact on how patients approach healthcare; responses used in challenge are referred to as problem-focused coping strategies. It appears palpable that what happens in one challenge that causes a person to exploit one coping approach may not automatically be the same specified for another hazard. It is evident that coping has to be observed from various implications since there are various archetypes to an individual within and outwardly, (Muhammad et al. 2012). Some coping strategies are associated with increases in positive actions and others increasing negative ones (Folkman & Lazarus 1988). Not being able to cope can make people feel excluded; have perceptions of vulnerability and outlooks of hopelessness against a backdrop of weakened health (Jones and Dutton, 2014; Luxford and Sutton, 2014; Wolf et al. 2014). Depending on how patients approach services, problem-focused coping may be one approach. This includes problem solving, information gathering, goal-setting and problem-orientation (for example, sourcing healthcare information and discussing with a professional) (O'Leary 1990).