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Online Medical Records

In order that citizens can take more responsibility for the management of their own health it is vital that there are systems of shared record keeping that enable people to record and manage their own medical history.

It is NHS policy that citizens should be able access their medical records; however it is sometimes difficult to get access to these records and online access would seem to the natural system for not only accessing data but actually sharing data between citizens and professionals.

One exciting online solution has been developed by PAERS (Patient Access to Electronic Records). PAERS is an independent company set up by doctors to provide tools for healthcare professionals to enhance services for their patients through the use of touch screen kiosk and web based technologies. The company is run by Dr Fraser Booth, Dr Lachlan Clark and Dr Brian Fisher.

Their online system enables patients to see their full GP record: letters, consultation notes, results, full problem list, allergies, immunisations. Data is linked to patient information leaflets so that patients can understand both their consultation records and their investigation results. The record becomes also becomes a portal to a range of other facilities that are automatically tailored to individual patient need.

Benefits of the system

Most patients want to see their health records. People say that they understand most of what they see without any change of clinician writing style. Although a minority, mainly those with psychiatric difficulties, are upset about what they see, they still feel accessing their record was the right thing to do. Record access appears safe, even for patients with serious illnesses such as cancer. Evidence of benefits includes:

• Increased trust in their clinicians and their practice
• Improved compliance in medicine-taking, self-care and preventative health behaviour
• Obtaining their own health information without needing to contact the practice (allergies, immunisations)
• Empowering patients to care for themselves more effectively
• Using consultations with their clinicians more effectively
• Saving time for themselves and the practice
• Correcting errors in the record
• Evidence shows better outcomes with less use of health care

Care planning could be significantly enhanced by patients seeing their plans, linking them with all the other personal information available and being able to get reminders for upcoming relevant interventions such as a review of blood pressure.

A Web 2.0 facility will be available in 2010. This will ensure a far more interactive service: secure messaging to the practice, automatic personalized links to national patient websites such as Asthma UK, integrated prescription and appointment ordering, the ability to add to the record, the facility for PCTs to send messages to patients anonymously. It may become possible also for patients to add over the counter medicines and medicines from other sources such as the dentist to their record. It may also be possible to alert patients to drug trials to which they may want to contribute.

It would also make sense to link these initiatives to the parallel approach being taken within the local authorities to provide better information to people using social care or for those who may not need social care if they have access to the right information and resources.