Healthcare records online: real purpose?

The government has entered a race to get the NHS ‘digitised’, with the ultimate goal of a paperless health service by 2018. Although most people will agree that this is the right course of action to transform the NHS into a modern organisation fit to address the health problems of the 21^st century, many have doubts about the government’s approach and the feasibility to meet the tight deadlines.

A very good example of this is the government’s pledge to give patients online access to their records by 2015. Last week, eHealth Insider published a survey of GP practices, which reveals that the majority of them were not ready to implement and disagreed with the government’s deadline.

This does not come as a surprise, nor is the fact that just half of those polled felt that records access would be useful.

Several factors can explain resistance amongst GPs. Firstly, many are focusing their efforts on current priorities associated with healthcare reform, from GP contract negotiation and CCG changes to implementing various pressing IT projects to support them.

Another issue is that presently when doctors write patients notes, it is for their own reference or for colleagues. Giving unmoderated records access to patients could lead to an increase in workload for GPs as they would have to reassure unduly worried patients or explain terminology.

Equally doctors are reluctant to dumb down clinical notes to make them patient friendly as this would result in a lack of precision and accuracy needed to ensure records are safe and effective. So is the answer to have two sets of records, one for the clinician and one for the patient? And an increased workload for healthcare professionals?

On top of that, ethical considerations have been raised. One concern expressed by GPs is that patients could be coerced to share their records with family, employers and insurance companies and a variety of other people who may wish to have access to them.

In a previous blog, I wrote about health literacy and the fact that 43% of people aged between 16 and 65 years old are unable to “effectively understand and use” everyday healthcare information. Surely if these people were to access their records – assuming they had the desire to do so- it would not necessarily prove to be the empowering experience that is promised!

Empowering patients to become active participants in decisions about their health and enabling them to look after themselves better surely must be the crux of the government’s plans to enable online records access. This however will only work when it is part of an overall approach to building health literacy amongst patients and encouraging the emergence of a new type of patients willing to share the burden of care and reshape their relationships with health providers.

Technology is no doubt a great enabler, not an end in itself.