Patients are being let down by lack of electronic health records, finds review

BMJ 2016; 353 doi: (Published 02 June 2016) Cite this as: BMJ 2016;353:i3131
  1. Helen Mooney
  1. London

Patients have only limited access to electronic health records and their expectations are not being met by the NHS, according to the findings of a review into the roll-out of patient records across the United Kingdom.1

NHS organisations are also missing out on ways to save money and improve patient care because of the lack of large scale implementation and access to personal health records.

The review of current UK activity in personal electronic health and care records (PHRs) was carried out by the Royal College of Physicians (RCP) Health Informatics Unit for NHS England. It found a lack of available information on the use of PHRs but concluded that the numbers of both individual and organisational users are low.

"The functional maturity, implementation and uses of PHRs are also relatively limited," it said.

The review found that where PHRs are being used the focus has been on enhancing information sharing and communication between patients and their care providers and not on changing the methods of delivering care or saving money.

"The failure to fully utilise PHRs for health service improvement projects may mean that potential improvements in cost efficiency and effectiveness are not being realised," it warned.

Attempts to modernise NHS technology and get extensive take up of PHRs across NHS organisations have been dogged with problems.

The Labour government attempted to launch electronic medical records as early as 2002, but the programme was subsequently scrapped after costing the NHS more than £10bn (€13bn; $14bn).

Under the previous coalition government, the health secretary, Jeremy Hunt, announced the NHS would go paperless by 2018.2

Earlier this year Hunt once again launched a bid to kick start the drive to a paperless NHS, announcing that £4bn would be set aside for electronic records and online appointments as well as prescriptions and consultations.3

Jeremy Wyatt, the RCP Health Informatics Unit lead for new technologies, conducted the review and said that although many people now wanted to get more involved in managing their health, they found it hard to do so.

“Personal health records are a tool that can facilitate this, but at present they are only available to restricted groups of patients," he said.

"The evidence shows that more work is required to develop and improve the user experience in order to better understand the wide variety of ways that people can use PHRs to support their own health, to increase uptake and usage of PHRs."

The review found that where a PHR is used, it tends to be for a specific purpose with a targeted user base—for example, PatientView, which is widely used by patients with renal disease to access their test results.

"This suggests that there has been a lack of market research on what patients want with regard to wider uses and the ways in which care professionals and service managers might find PHRs beneficial," said the review.

The review concluded that "as the understanding of patients’ and care providers’ requirements and preferences becomes clearer, it is important that PHRs are able to evolve to meet those needs.

"It is vital that patients and health and social care professionals are active participants in the design, implementation and appraisal of PHRs."


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