I’ve just emailed my GP asking her to give me online access to my medical records. It was quite a palaver as I couldn’t find her email address, or the email address of the practice after searching on Google, and the practice doesn’t seem to have a website. Eventually I had to ring.
Why have I never done this before? I spend half my life online. Most of my work is done online. I shop, manage my finances, and do my taxes online. My web footprint is huge. So why have I never asked for access to the most intimate details about me that are kept on a computer about a mile from here? Well, it never occurred to me — just as it hasn’t occurred to virtually everybody in Britain and the entire audience at a Cambridge seminar I attended last night full of the digerati. It’s culture, stupid.
The audience was urged to contact their GPs and ask for online access to their records by Dr Amir Hannan, the GP successor to Harold Shipman in Hyde, Greater Manchester. His challenge was to rebuild trust in a practice where it had been totally destroyed. The day before he started there was a sit down protest in the surgery, and Shipman’s relatives came and took away all the computers.
Dr Hannan saw giving patients access to their records as an important step in building what he calls a “partnership of trust.” Some 600 (3%) of his patients now have access to their records online, and he believes that moving to “real time digital medicine” is transforming health care.
Patients can access all the information about them, make appointments, order repeat prescriptions, and access lots of information and decision support tools. The result is increased health literacy, better concordance, improved accuracy in the records, and a trusting adult to adult relationship that itself improves health. Those patients who have online access to their records can’t understand why everybody doesn’t do it.
With the EMIS system, which is used by 60% of GPs, it is easy, and cost free, to give patients access to their records. But only 40 practices in the country have done it so far—we are very much at the beginning of this revolution. Dr Hannan, a huge enthusiast, says that he has had no problems from the change, but interestingly most of the questions from the audience were about the downside of the change (security, confidentiality, etc) not the considerable upside.
The meeting also heard from Dr Mohammad Al-Ubaydli, a doctor and founder of Patients Know Best, who has studies personal health records at UCL’s Centre for Health Informatics and Multiprofessional Education.
A personal health record is one that the patient rather than the doctor controls, and this is surely where we must be headed. There is published evidence showing that personal health records can produce many benefits, are particularly valuable for patients with chronic conditions, and improve compliance and care. Interaction is better than simply access, and “coauthorship” between patients and doctors creates accuracy and concordance.
You can access both presentations at http://wiki.patientsknowbest.com/Patients_Know_Best/Lectures/2009.02.17_Using_Personal_Health_Records_in_the_NHS, and I urge you right now to ask your GP for online access to you records. Both you and she will benefit.
Competing interest: Richard Smith is an unpaid member of the board of Patients Know Best and a true believer that the web can ultimately transform health care as it is transforming so much else.