PATIENT RECORDS
that we have to do something about it, that there’s a huge danger of records being ac- cessed in an inappropriate manner.
“Then you have this small but vocal minori- ty saying how important it is to have shared electronic records. But most of the public haven’t even thought about this. They clearly presume that records are shared much more than they actually are and are generally surprised when they fi nd out how little is shared. But the public is often clev- erer than they are given credit for. They un- derstand there’s a balance between acces- sibility and the danger of a privacy breach.
“So, we have a debate that’s polarised be- tween two small minorities, but the ma- jority of people don’t think you have to be fundamentalist one way or the other and that you can have a balance. Clearly there will be breaches of security – people who say you can make it foolproof are utterly wrong. There will be privacy breaches, there always are and always have been, so we have to get the balance right.
“The lesson from all this is that you can’t just impose change on a powerful, educat- ed workforce, of the sort we have in health- care. You can’t just tell doctors to do things. That was one of the mistakes of Connecting for Health. They didn’t realise how easy it
is for people in the healthcare service to re- sist change, which they did.”
In summary
The Government has decided to press ahead with the Summary Care Record, al- beit at a more cautious pace than the previ- ous version of the programme.
But Dr Potts said the fl aws in the theory and practice of the detailed electronic re- cords are only amplifi ed in the summary record.
He explained: “It’s clear that most of the time, it’s not doing anything useful. We have found situations when it’s actively im- peding care, as there are issues with data accuracy that Connecting for Health always tried to gloss over.
“Yes, there are situations where it is use- ful, or could be. Going back to my mum at A&E; even as a retired GP, she can’t re- member what drugs she’s on, because she’s on about 15 kinds. So, it would have been convenient if someone could press a but- ton and that list appeared: not that anyone tried to do that, of course.
“The Summary Care Record, like all sys- tems, suffers from a take-up problem. Why
would you use it, until it becomes common- place? But you need people to start using it, otherwise nothing’s ever going to happen. Uptake was already stalling before it got put on ice. There was a presumption that once uptake began, it would keep going up and up, but as we’ve seen with Choose and Book, there’s been a lot of non-use that has continued for a lot longer than senior peo- ple thought it would.
“There’s no clear solution. If you can make it work, it could be useful, but it comes down to what people do and how they work. It must suit their workfl ow. It can’t be too fi ddly or have too many security checks. If they change rota, or don’t have their security card on them, or it takes a long time to log on, then it’s ceasing to be useful for them and they won’t use it. You also have to recognise issues of accuracy; just because it’s in the record, doesn’t mean it’s accurate. Health- care professionals know that fact – bet- ter than some of the people at Connecting for Health. That’s the reality we have to face up to.”
Dr Henry Potts
FOR MORE INFORMATION Visit
www.chime.ucl.ac.uk
national health executive May/Jun 11 | 27
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