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As the new sharing model of EDSM V3.01 is rolled out across the country, we get a lot of people asking us what it is, how it will affect them and if they need to know about it. This guide will explain everything you need to know and will explain how it will affect you as a SystmOne user. Essentially, if you use SystmOne in almost any capacity, this new way of sharing patient data will have an impact on you.

OK Explain what EDSM actually is.

With regards to sharing patient records in SystmOne, there are three options (two are in use in most of the country but there is a third "middle" option that was trialed in a fee places and never received a bigger roll out). These are the "Old" Data Sharing Model, the "New" Data Sharing Model and the Enhanced Data Sharing Model (V3.01). Version 2.01 is the one that received a small, limited trial and is the least used - therefore we will focus mainly on the Old model and the Enhanced model.

The Data Sharing Model (DSM) is the mechanism by which patient records are shared in SystmOne. Areas using the Old DSM must put point to point shares in place to see each other's data. This means that for a GP surgery and a District Nursing team to be able to see each other's data, they must each open the patient record, navigate to the record sharing area, and manually put in a share to each other's units (information on how to do this is provided below). You can choose which level of data sharing is available to each unit, and can make parts of the record completely private (so even though a share is in place, these parts are still hidden from the unit you are sharing to). This method does seem to work well, but it is very tedious and complicated for admin and clinical staff to set up. There are also other disadvantages which will be explained later. 

The EDSM release e3.01 is a new SystmOne sharing model which supports the White Paper Liberating the NHS, the recent Caldicott2 review and the NHS Care Records Guarantee. In EDSM, the patient is asked whether they would like to Share In and Share Out at each service unit. Also, specific events in a record may be made private. In a scenario, when a patient visits their GP, the doctor will ask them "would you like to share your record held here with other services who are/will be proving you care in the future?" The doctor will also ask "Would you like to share you data recorded at other services with this GP surgery? If the patient answers yes to sharing out, their information will be shared to any other units where they have been asked to share IN and answered "Yes". Similarly, if they answer "Yes" to sharing OUT, any other units to which they answered "Yes" to sharing IN will be able to see data recorded at their GP. 


Imagine there is a shared pool of data. This is the shared part of the record that is visible at care services that have the patient’s consent to view it. If the patient consents to Share Out, then data is visible in the shared pool. If the patient consents to Share In, then the care service will be able to view the shared pool.

In the example shown, the GP surgery and District Nurses contribute to the shared pool and can see the shared pool of records. Although the smoking cessation clinic shares to the pool, they cannot see the shared records from the other units, because the patient opted at the smoking clinic for share out, but not share in. Maybe the patient decided that their full GP and DN record is not really relevant to a smoking clinic and decided for them not to be able to see it. 

A full and detailed run down on how to use EDSM is available as a PDF download direct from TPP's website. 


What if we are currently on the Old or New sharing models and we register a patient from an EDSM area? 

Well in this case you will be registering the patient on the EDSM - once a patient record is converted, it will not go back to a previous sharing model. 

The screens below explain the changes you will see when your area is converted to EDSM, or if you receive an EDSM patient at your organisation before you move over to EDSM.

The above screen may be shown when retrieving a patient record, on registering a patient or from a task relating to record sharing. This is the screen that is shown for EDSM patients. 

You will now ask the patient if they wish to SHARE OUT. The options are YES, NO, NOT ASKED. Answering YES will add the data at your unit to the shared pool, NO will keep the information out of the shared pool and CONSENT NOT ASKED will let you answer YES - SHARE RECORD (you must enter a reason why) or NO - DO NOT SHARE THE RECORD. 

The options for SHARING OUT are similar and are shown on the screenshot below. 


How do I see this information in the Patient Record, and change it if necessary? 

It is entirely possible that a patient may change their mind about their sharing preferences, and this can be updated from within their record. 

1. Open the required patient record and click on the Administrative Tree tab.

2. Click the Record Sharing node (this used to be called Shared Care in previous versions).

3. The current shares in and out are displayed. 

4. Click the blue hand icon just above the sharing out section to open up the sharing preferences dialog again.

5, If you see a red cross icon in the Patient Status Markers area, it indicates that this patient does have some data at other units that are NOT visible to you. Bear this in mind especially when prescribing.

6. To make individual entries in the new journal private, select the entry and click the blue hand icon to display the options below. 


Further reading

The NHS Care Records Guarantee

Liberating the NHS Whitepaper

The Information Governance Review