Intended for healthcare professionals

Rapid response to:

Feature Oncology

Disruptive technologies making cancer care more patient centred

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5608 (Published 06 December 2017) Cite this as: BMJ 2017;359:j5608

Rapid Response:

Re: Disruptive technologies making cancer care more patient centred

The Present
The Traditional Model of communicating with patients; at present some professionals and health services deal with patients as a primary school teacher deal with a class of pupils. The pupils must do what the teacher orders and the patients must do what they are told to do by the professional. This is fine if the professional matches the plan perfectly to the patient and if the plan is communicated perfectly to the patient. This does not always happen - not least because only a small part of the information is currently available to the patient.

Changes in the condition or complications will occur and if these changes have not been explained to the patient they may produce further need for the patient to take professional advice. Full access by patients to records, shared plans, clinical details and natural histories would allow patients to make better responses to crises and changes. Patients can be educated to respond differently to these situations and to use their medical records in a constructive way that may prevent the need to contact a service provide for advice.

Patients and families feel better having the truth but currently may wait days weeks or months to hear (but not see) the results that have been available but not shared with them for days weeks or months (or indefinitely).
So, what basic assumptions, values, norms and artefacts are changing or need to be changed and where do intelligence, information, data and data processing fit in with these changes and where do intelligence, information, data and data processing fit in with these changes? Patients won't find out what is useful for them in a record if they aren’t encouraged by professionals to access the record.

The future

The public will increasingly utilise and manage the plans and goals within he records to manage health through their own actions. More Health care will take place in primary care ( * WHO) than in secondary care.. Governing rules will develop to allow collaboration of the public with professionals and the public may increasingly have roles in clinical and information governance. Electronic records will change many of the basic assumptions and practices of health care and it will be necessary to inform, educate, arouse and enlightening the national consciousness of their role in health care records maintenance. The majority of the population know very little of the work and have been given information by way of preparation for the introduction of the electronic care record.

The States’ health services’ producing capacity may expand as citizens become expert in the use of the electronic health records and perhaps participating in collective responsibility. The patient is the one person who will be continuously having an interest in the structure, process and outcome of their care. If the patient and carers do not have access to the whole record any mismatch of selected information and patient/carer requirements of information may not be detected. Individuals and organisations will increasingly implement and service the global health record and in time assist in the design and implementation of the global health record.

Competing interests: No competing interests

10 December 2017
Richard Peter Fitton
Retired GP
Tameside and Glossop CCG
The Old Vicarage Crowden Glossop Derbyshire SK13 1HZ