Intended for healthcare professionals

Letters Supporting patients

The future is already here

BMJ 2011; 342 doi: (Published 03 May 2011) Cite this as: BMJ 2011;342:d2702
  1. Benjamin C Brown, primary care academic clinical fellow1,
  2. Amir Hannan, general practitioner2
  1. 1University of Manchester, Health Sciences—Primary Care, Manchester M13 9PL, UK
  2. 2Haughton Thornley Medical Centres, Hyde, Cheshire SK14 1JY, UK
  1. benjamin.brown{at}

The roundtable discussion on shared decision making cited an “asymmetry of information”—where patients cannot see written details of their treatment—as a barrier.1 One proposed solution was to provide patients with their health records on a memory stick.

In the words of author William Ford Gibson, “the future is already here,” it’s just not evenly distributed. At Haughton Thornley Medical Centres in Greater Manchester (, 10% (1189/11 890) of patients regularly access their medical records via the internet using EMIS Access ( This culture of real time digital medicine has developed over the past five years and has many advantages. These include empowering patients; supporting a partnership of trust between patient and clinician; improving patients’ understanding of clinical pathways by incorporating localised versions of the Map of Medicine; and enabling patients to do more for themselves safely, effectively, and with a better experience. All these benefits have contributed towards shared decision making.

We are extending this service to nursing home residents, some of the most vulnerable members of society and high cost users of the NHS. This is more complex, however, because many do not have the capacity to participate in shared decision making. In these cases, nurses will act as patient advocates and are being trained to access residents’ personal information when clinically necessary.

Enabling patients to access their own medical records is an essential step in implementing shared decision making. We hope that this will be achieved cost effectively in a variety of patient populations.


Cite this as: BMJ 2011;342:d2702


  • Competing interests: None declared.


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