Chris Frith Greyfriars Surgery Herefordshire CCG ITC clinical lead

Viewing Medical
Records
Chris Frith
Greyfriars Surgery
Herefordshire CCG ITC clinical lead Why do it?
•  Educational/informative •  Correct records •  Patient empowerment
Timeline
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1984 Brian Fisher sharing patients records paper/portal(PAERS)
2000 Greyfriars go paper-light with EMIS LV
2003 Guidelines DoH/GPC
Sept 2003 PAERS demonstrated at EMISNUG conference
2004 Rob Murgatroyd EMIS Project Manager attended a practice meeting
2005/6 Greyfriars went live with beta software, HMC informed
2007 Presentations to CfH, West Midlands & NUG
17 patients Greyfriars, 250 nationally (mostly Hyde)
2008 EMIS roll out LV, Patient Leaflet/Poster & Wyvern radio 2010 EMIS NUG committee d/w Henry Pares DH
2012 RCGP Roll Out Report
April 2014 GPs contracted to provide access
Dilemmas
•  Carers/spouses/parents access
•  Record checking
•  Security (ID)
•  Results seen before clinician has
commented
•  Digital inequalities
Greyfriars Patients
•  Uptake very slow till this year
•  1% (60 patients) till this year now 5%
•  Encouragement/benefit
•  Enrolment
Demographic Usage
Study Presented by Dr Fisher 2010
•  Average age: 55y (18-97y) 45-65
•  M:F ratio: 50/50
•  91% white •  51% generally well but had an ongoing
condition requiring regular medical
treatment
Each respondent used Access for an average of 7 things
Tests
78%
Letters
62%
What has been written about me 60%
Check Accuracy
50%
Ensure all relevant info told to me
50%
Info about treatment
49%
Monitor my health
39%
Check I understood
36%
Plan for discussion with the doctor
25%
Help me make decisions about my health
24%
Frequency of use
•  86% accessed (14% technical problems or
not ill)
•  Majority looked 3 times or more
•  Those in poorer health used it more
(p=002)
•  No sig relationship between number of
uses and age or ethnicity
Efficiency
•  Over half felt that accessing records before
appointments saved time during
consultation
•  Patients were able to focus on the most
important issues eg results seen were
understood
•  Over half wanted to share records with
other healthcare providers
Patients concerns
2011 Study on Patient Focus Groups for The Health Foundation
•  Will not understand the records
•  Forget the password
•  Confidentiality will be breached
•  Will find an unknown illness or opinion
How to do it
•  £££
•  Educate
•  Open philosophy/confidence
•  Adoption of the belief by whole Practice
Team
•  Public expectation
Results of Access
•  42% felt more likely to take medication
•  64% felt it had helped them to follow lifestyle
changes
•  56/57% helped them understand why they needed
to take medication/change lifestyle
•  76% felt more involved in their health care
•  62% felt they understood better what had been
previously discussed
•  9% more worried, 65% less worried
•  54% felt more confident in their GP
Future developments
•  Correct data
•  Express choices
•  Data entry
•  Linkage to knowledge/risk analysis/
motivational tools
•  Access Health Pathways/Care Plans
•  Clinicians access to patient s plans/pathways
Thank you
•  Roz Foad & PHCSG
•  Brian Fisher & PAERS
•  David Stables, EMIS & NUG