On Thu, 5 Feb 1998 10:06:54 -0000, you wrote:
>Fleur, you haev a charming belief in the content of GPs computer
>systems.
>The fact is many GP systems are almost
>devoid of any useful data except prescribing and new patient check data.
Very condescending, my dear chap.
DIN has direct understanding of the (de-identified) contents of many
many GP systems and allow me to assure you that Fleur is right to be
concerned.
>This is a scandalous waste of resources for several reasons and the
>advent of locality commissioning offers the chance to make in roads into
>this neglected area
Modern networking and data storage systems allow groups of doctors to
manage their combined patient records under clinical rules of access,
thereby assisting locality commissioning. This is not the same thing
at all as handing their records lock stock and barrel over to a system
neither owned nor controlled by the co-operating practices.
Any identified patient data can be explosively damaging in the wrong
hands. It doesn't have to be complete, it can be 'just repeat
prescribing', and still do harm.
Remember, the GP is the one who carries the legal can for releasing
the notes, not the employee who 'leaks' them.
>Although you are right to raise the ethical issue the medical
>issue is just as inportant.
What issue is this?
The NHS manager's right to access any patient's clinical records at
any time for whatever purpose they see fit? Or the NHS clerk's right
to sell patient records to private detectives for £200 a time?
We've had this debate before the Caldicott committee sat, and I had
hoped the ethical ideas developed then might have penetrated the outer
darkness of the uncritical enthusiast.
Handing over your patient records to NHS-run computer storage opens
them to casual abuse by the NHS employees who run the storage
facility, as well as to systematic abuse by NHS management.
Access to identified records needs to be on a 'Clinical Need to Know'
basis only, unless the patient gives informed consent for each
access.
If NHS data warehousing services could give watertight guarantees
that the above principle would be upheld at all times and at all
management levels, all would be well.
Unfortunately, such guarantees are rarely if ever forthcoming.
Beware the enthusiast who starts a such a project and fails to obtain
one!
Paul
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Dr. Paul Steventon
Chairman Doctors Independent Network
Fitznells Manor Surgery, Ewell, Surrey
Tel:0181 394 1481 EMail [log in to unmask]
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