Friday, 8 April 2011

Summary Care Records

Last week two little envelopes plopped through the letter-box - one for me, one for husband.  They contained an information leaflet and an opt out form re the NHS Summary Care Record (SCR).

SCRs are computerised data of patient information containing demographic details, medications, allergies and adverse reactions; information that could make all the difference when a patient needs emergency or unplanned care.  Well, that's what the blurb says!

The SCR has a chequered history, concerns being aired with regards to those who might gain access (porters, Mrs Miggins the domestic, etc) and thus the security of personal computerised data and also the pace at which it was being rolled out.

Those who like IT (and the then government) were hell bent on reaching critical mass before end of March, 2010; the government to push its baby through prior to the election and the five Strategic Health Authorities taking part in the hurried roll out becoming eligible to take advantage of central funding.

This haste despite researchers at UCL finding inaccuracies in stored data, i.e, failure to indicate allergies or adverse reactions to drugs or indicating that patients did have allergies or adverse reactions when they didn't or listing 'current' medications that were no longer taken.  The researchers found that no patients suffered harm - but purely because doctors didn't trust the information and double checked it.

There was no evidence that records led to safer care although access to the database could reduce rare medication errors.  No clear evidence either that consultations were quicker and in some cases the use of the SCR made consultations longer.

The BMA expressed concerns about the speed of the roll out meaning that patients were not adequately informed about electronic records.  An independent evaluation of the early adopter areas found that seven out of ten patients were not aware of the SCR and therefore did not realise that they had given consent (by not opting out) and that their interesting little medical details were available for all and sundry to access.

Come the coalition government the whole SCR kerfuffle came under review, things looking good as in 2009 the Conservative party pledged to 'dismantle central NHS IT infrastructure' replacing it with local systems and Liberal Democrat health spokesman Norman Lamb called last year to an end to the 'obsession with massive central databases.'

But politicians aren't well known for keeping their word and honouring pledges, are they?  So the SCR has been given the green light again and it is go baby go!  The mass mail out has begun!

This time around it will be clearer that you can opt out.  I suggest that you do - for do not believe what you read in the pretty little leaflet.  I don't.  During my research today, I was lucky enough to find Summary Care Record Info - an eye opener by the excellent Dr Neil Bhatia - read and learn!  Home in on how your 'core' details will be added to!  Home in on everything!

Worried about security, will Mrs Miggins (the domestic) be reading your private data and selling the sordid details to The Sun?  Possibly yes!  Read this interesting article in Pulse which informs that celebrities (the most important people in the universe), politicians and other patients with 'sensitive' information will be excluded from SCRs.  Wonder why that might be?

While you're at it - you might as well read this!   Gives you a hint of who might be able to access your details in the future!  'I don't have specific reservations about giving pharmacists access to SCRs - it could have benefits in the future - but I'd actually be more interested in getting the basics right first.'

Anna :o]

Link: The Witch Doctor "If you have nothing to hide..."

12 comments:

Eliza said...

Scary, I'll be opting out.

Hold my hand: a social worker's blog said...

oh wow...scary!!!!

Doris

Frances Garrood said...

Interesting, thoughtful post, Anna, and you make some very good points. The only thing I would say is that those old brown patients' records envelopes (which are still very much around; in my GP's surgery, anyway) are pretty open to abuse, and Mrs. Miggins could happily read through them while dusting the filing cabinet (and probably does)!

HyperCRYPTICal said...

Thanks for your comments folks.

Francis: Very fair point and one that is used as an argument for electronic records. I would hope that the Mrs Miggins at the practice I attend does not - but possibly she does. Even if she does, she is just one Mrs Miggins and not the countless Mrs Miggins (and all her chums)that work within the NHS.

Pulled from the excellent Dr Bhatia' site: "I will respect the privacy of my patients,for their problems are not disclosed to me that the world may know." Hippocratic Oath, modern version (1964)

Massive central databases are directly opposed to this oath.

Anna :o]

HyperCRYPTICal said...

Sorry - mispelt Frances! Anna :o]

Frances Garrood said...

That's ok, Anna. I'm used to it!

Friko said...

Blimey, doesn't sound good at all, does it.
On the face of it I'd think that doctors and health professionals having access to relevant data would be a good thing, but it obviously can also be used for nefarious purposes.

Isn't that the case with all the data gathered about each and every one of us, in whatever field? There is no way round it, privacy is a thing of the past.

Cockroach Catcher said...

Fraud will be the next big business as organisations that are paid on a piece work basis including walk in centres and "help lines" can now fake on the number of patients they treat or take calls from. They can also target chronic patients like diabetes to visit them often, have various tests, get free wheel chairs etc. All sailing on the edge of legality but costing Consortia money. In NY, in the Russian area, they have signs in Russian advising Diabetics to do that and they claim from Medicare.

There will be no extra money, all from the pot the GPs hold and the fraud will be sophisticated.

HyperCRYPTICal said...

Hi Friko and Cockroach Catcher.

Friko: We are very much living in a 1984 Big Brother society - but arriving here has been very subtle and we have not noticed it or just accept it as we "have nothing to hide."

We are told what we can and cannot say which alters and confines our thought process. All citizens to some extent are deprived of their liberty.

As you rightly say information about us exists on many databases and we allow it - whether legal or not.

Please visit http://www.opendemocracy.net/ourkingdom/rowntree/database_state#

Our privacy and freedom of expression will continue to shrink unless we say "No!"

I feel I should state that I am not paranoid!

Cockroach Catcher: I can see it coming too! If there is profit to be made - big business will find it as I believe they are legally obliged to do so re their shareholders? It will not matter to (them) that Consortia have a limited pot of gold. Greed and shareholders will be the driver.

Doesn't look rosy for GPs, does it

Anna :o]

Witch Doctor said...

"Privacy is a transient notion. It started when people stopped believing that God could see everything and stopped when governments realized there was a vacancy to be filled."

—ROGER NEEDHAM

HyperCRYPTICal said...

Hi WD

Well observed by Mr. Needham!

Anna :o]

Reeder said...

Fraud will be the next big business as organisations that are paid on a piece work basis including walk in centres and "help lines" can now fake on the number of patients they treat or take calls from. They can also target chronic patients like diabetes to visit them often, have various tests, get free wheel chairs etc. All sailing on the edge of legality but costing Consortia money. In NY, in the Russian area, they have signs in Russian advising Diabetics to do that and they claim from Medicare. There will be no extra money, all from the pot the GPs hold and the fraud will be sophisticated.