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Patients must have control of their medical records

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e5575 (Published 21 August 2012) Cite this as: BMJ 2012;345:e5575

Rapid Response:

Re: Patients must have control of their medical records

The concept of patients controlling their records is valid and is broadly being tested and managed with expectant mothers and their peri-natal records. Undoubtedly, giving patients control of their own records will increase their participation in their care. Furthermore, converting records into electronic format is contemporary and probably increases the efficiency of clinical care; for example, avoiding the accumulation of multiple sets of fragile notes.

Conceptually there are two ways of modernising current records. Firstly, transferring existing records into an electronic format that can be accessed by all healthcare providers irrespective of location. Secondly, individual records being carried by patients that can be transferred between healthcare providers. In general practice we have observed conversion of written notes into an electronic format. Secondary care providers are starting to adopt electronic notes systems in certain departments throughout the UK.

Considering current systems in hospitals everyone who needs to access patient electronic records has individual login credentials. The privileges are dependent on their role and sensitive information may not be routinely accessible by all users. These systems already exist in current hospitals. The utopia would be an integrated computer system such as those used by high street banks so that each ‘branch’ (clinical environment) could access the same information which could be modified by a user who had the appropriate authorisation. Such systems are well encrypted and maintained by professionals whose specific role is to do that so that. For instance, storage space and system updates may be seamlessly applied.

Focus should be given, once again, to a NHS-wide integrated system. Whilst the piecemeal cost when added up of every separate electronic system used in the UK is difficult to estimate, it is likely that a single ‘universal’ system will eventually be more cost-effective to maintain. Perhaps this should be the focus of our attention. A patient may well need to carry limited information (much like an account number and password) so that their individual records may be unlocked and accessed wherever they are in the UK. Clearly choosing a universally accepted system will not be without difficulty. Nevertheless this should be considered a priority for the modern NHS.

Competing interests: No competing interests

24 August 2012
Michelle Carey
Foundation Year 2
Jaspal Phull
University Hospital of Wales
Cardiff CF14 4XW