NHS record keeping at its finest
I’ve declared my hand when it comes to electronic health records – I think they’re a good idea, I think we use security as an excuse for the health sector lagging behind in this area and I believe they’d make my life simpler.
Now I see a glimmer of hope on the horizon. The NHS are currently running a survey to consult patients on what features they’d like to be included in any patient accessible electronic patient record. There’s the usual stuff – access to test results, access to your health records, ordering repeat prescriptions online – nothing ground breaking but all good stuff that to be honest we should have done years ago, so I’m very supportive of the concept.
I am a bit nervy about this though. It smacks of a consultation aimed at designing a super-dooper system (a good thing) but I’m yet to see much evidence of people addressing the behavioural change needed to implement such a system. Let me explain…
We’re not trying to split the atom here, many electronic patient record systems exist already. Indeed, I can upload all my CGMS and pump data onto the interweb and give my Dr a secure password to log on and view them at any time. I’ve never used the feature because unless it’s printed out my Dr doesn’t look at it! The technology really isn’t the issue.
What we really need is to drive a change in behaviour. A change where it becomes the norm for patients to interact with their healthcare team online and have access to their own health records whenever they want or need it.
This is by no means a damning indictment of the whole medical profession. There are many clinicians out there who will correspond by email, will access patient data online and who see the internet as a valuable tool rather than an evil terror. But that’s yet to become the norm. My old GP had a computer in his office, it was in the corner acting as a stand for a plant and a bunch of drug company leaflets. I’m sad to say in my experience that has been close to the norm.
I’ve completed the NHS survey and in the comments section I’ve talked about the need to ensure that we get clinicians on board with the project. We need to spend time and effort looking at how this will change the way people do their jobs, day to day. Otherwise, we’ll have a nice shiny new electronic patient records system with no meaningful usage. If that’s going to be the case lets save the money and I’ll stick to managing my diabetes results with Excel, it’s cheap and it works.
The survey is really quick so if you’re an NHS patient please take a minute to submit your views. If you’re not an NHS patient (or you’ve completed the survey and just can’t resist talking about it some more) let’s have your thoughts below.
I think the only way we’re going to get wholesale take-up of integrated medical records, etc., is to wait until this generation of medical professionals dies and is replaced by a new generation who have been brought up immersed in IT and the Intermaweb.
Thanks Tim, that fills me with optimism! I’m hoping a bit of patient pressure and no doubt some kind of financial incentive might also help. Since they started paying him for it, my GP is exceptionally keen on taking my blood pressure and giving me a flu jab. We just need to find a way to encourage the same kind of enthusiasm around IT.
Less flippantly, I do think there is an inherent problem with introducing IT systems, in that Docs will not see the advantages of new systems unless they already have a good grounding in IT and the Intermaweb.
Some crusty old quack who’s never even used Amazon to order a book and doesn’t know how to email, will simply not see the benefits of an integrated online system and therefore will not use it – regardless of any financial incentives. In their view, the old paper system works, so why change.
And certainly from what we both know of docs around the country, there are certainly a lot of crusty old sawbones around.
I think electronic health records are a great idea, and I’d love to have easy access to my medical records. I do agree with you though, in that it’s not just about getting the system up and running, the health professionals have to be willing and able to use it. I think it’s not just about getting them using the tech, it’s also about them getting used to the idea of patients having full access to their health records and test results.
I think as diabetics we’re more used to actually seeing test results and discussing those with a doctor (well if we’re lucky and have a good doctor!), but a friend of a friend who was diagnosed with cancer had to fight every step of the way to get her results, because the doctors just couldn’t understand why she’d want them. I think one of the important things in getting the system to work would be overcoming attitudes like that. Not entirely sure how you’d do that though…
You’re right Angie, the over-enthusiastic paternalism is a bit of a killer at times. I think patient attitudes can affect that but its going to be a long haul!
Great discussion! Here in the States, hospital organizations–and government run hospitals–will need to mandate electronic medical record keeping to force Docs to use it. Independent physicians will simply say they don’t have the time.
Ahhh. Yet another great discussion happening across the pond.
I’ve spoken with Doctors, CDEs and Nutritionists in the past. It’s a “legal and privacy” issue. Not ONE uses email interaction with patients. They download data all the time, once you are At the appt and have paid for it. Suckage.
I am with Tim. Generations of the old, well, they will be in the past soon. Morbid but true.
@CALpumper Morbidity may sucketh, but the sun still rises!
@CALpumper “Legal and privacy” issues are the last retreat of the truly ignorant. It’s shorthand for “we don’t want to do this”!