House of cards

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39171.643368.47 (Published 12 April 2007) Cite this as: BMJ 2007;334:772
  1. Michael Cross, freelance journalist
  1. London
  1. michaelcross{at}fastmail.fm

    Will private initiatives allowing patients to access their health records threaten the UK's national programme for IT, asks Michael Cross

    A new private venture is offering NHS patients the chance to inspect their complete medical record, in electronic form, on any personal computer. Health eCard, being piloted in north London, is the latest of several initiatives which aim to give patients access to their medical records by using IT (information technology). Although the concept of electronic “patient held records” is not new, the technology seems to be coming of age—kindling debate on safety, confidentiality, the amount of information to which patients should routinely have access, and the potential impact on NHS resources.

    Allowing patients to view their own records is one goal of the £12.4bn (€18bn; $24bn) national programme for IT in the National Health Service in England. However, initiatives led by general practitioners and commercial suppliers are moving more swiftly and allowing more comprehensive access than has been promised by the “official” system for access to records, which is due to go live later this year.

    Practical matters

    Although all parties agree that using IT to give patients access to their records is a good thing, there is fierce debate over several practical matters.1

    One is whether records should be accessible over an online network (usually the internet) or stored in a portable medium in a form that can be displayed via personal computers. Health eCard takes the second option. Participating patients buy a smartcard that is similar to a credit card but is equipped with an adapter allowing it to be plugged into the USB (universal serial bus) socket found in most current models of personal computers.

    Copies of records are downloaded from the general practice's system via a one-way connection box that the company provides free to GPs. …

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