BMA warns against letting patients have access to their electronic recordsBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d206 (Published 12 January 2011) Cite this as: BMJ 2011;342:d206
Plans for NHS patients in England to take control of their own medical records have received a cool reaction from the BMA.
The association’s response to the government’s vision of a computerised health service, set out in its paper Liberating the NHS: An Information Revolution (www.dh.gov.uk/en/Consultations/Liveconsultations/DH_120080), also warns of GPs being deluged with emails from patients.
The government’s paper, published last autumn, proposes a locally led strategy for computerising the NHS and for patients to have greater access to electronic information, including their own medical records.
In its 20 page response the BMA sounds a note of caution on the cost, likely benefits, and ethical acceptability of the plan.
Chaand Nagpaul, a GP and member of the BMA’s working party on information technology, said in a statement, “Improving NHS IT while the NHS is under huge financial pressure will be extremely challenging.
“While the principle of patients controlling aspects of their records is a good one, there must be safeguards to reduce the risks involved in sharing such sensitive data.”
The BMA’s response says that some information in health records may not be suitable for sharing with patients. It cites examples, such as reminders to doctors to look up the management of depression in pregnancy or the appearance of alarming terms such as multiple sclerosis. “Whilst patients may wish to have access to such information, it will require a change in practice,” it says.
Enabling patients to access their records “should be a gradual process” implemented in stages only after successful piloting, the BMA says. “There should only be investment in this area if evaluation provides evidence of patient demand and clear benefits.”
Privacy is another concern. “The one significant element which we feel is absent is confidentiality and the need to balance the benefits of new technologies with appropriate information governance models in order to protect patient data,” the response says. It warns that commercial online services and internet social networks may not be covered by UK or European Union laws on data protection.
Patients should also be better informed about secondary uses of data, for audit and research, and should be allowed to opt out of having identifiable data used for such uses.
While backing the coalition government’s emphasis on local choice of IT systems for NHS organisations, in contrast to the last government’s National Programme for IT, the BMA raises concerns about the cost of computerisation. IT systems have “significant implementation costs” and a “significant time lag” before any resulting savings appear.
The BMA is also concerned about the prospect of GPs communicating electronically with patients. Although this may have advantages, such as reducing patients’ temptation to seek advice and treatment from unregulated websites, potential dangers include the risk of missing symptoms that would be spotted in face to face consultations and the threat of “a deluge of communication” diverting clinicians from seeing patients.
“Electronic communication needs further piloting and should be introduced on a clinician voluntary basis,” the response says.
Consultation on the government’s white paper closes tomorrow (Friday 14 January). The Department of Health is expected to publish an information strategy by early summer.
Cite this as: BMJ 2011;342:d206
Liberating the NHS: An Information Revolution—Response from the British Medical Association is at www.bma.org.uk/ethics/health_records/inforevolution.jsp.