Thanks to those who have helped with this piece of work.
Here is a initial report based on the responses of GPs who replied about how
they dealt with patients who ask to look at their records.
Any comments can be sent to me or the list as people see fit. I will update
the report to reflect any new insights or reports of practice recieved.
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Evidence gathered from gp-uk (8 e-mails) suggests patients accessing
records:
§ when they percieve that they have been the victim of negligence;
§ to support an insurance or benefits claim;
§ to challenge or clarify percieved record contents
The most common 'types' of patients accessing records, on this evidence, are
the 'mentally ill' or those who had received protracted hospital treatment.
The requirement to support understanding is determined on a case by case
basis with experiences ranging from a few minutes to check a record entry to
over half an hour with the subject cropping up in five subsequent
consultations. The number of requests reported ranges from one or two a year
to one in six years. There is evidence to suggest that more patients might
take up the option of viewing their record if it did not 'waste' the GPs
time (Jones 1992) or feel that they would not be labelled a "troublemaker"
(Lipsitt 1980).
Overall it appears General Practitioners, as a group, remain unclear about
responsibilities to the patient when faced with the situation and deal with
it in different ways. This seems to be determined by the needs and
persistence of individual patients. Some respondents reported consulting
their Medical Defence Union as a first step. Some of the responding GPs
offered full access to records both computerised (on screen or print-outs)
and paper (including copies), others paper only, others are using the 1990
Act threshold and others are invoking the ability to prevent the disclosure
of information thought to be detrimental to the patients health.
References:
Jones RB 'Patient on-line access to Medical Records in General Practice'
Health Bulletin March 1992:143-149.
Lipsitt DR 'The patient and the record' New England Journal of Medicine
1980;302:167.
Rob Wilson
Research Associate
Sowerby Centre for Health Informatics (SCHIN)
School of Health Sciences
University of Newcastle
Newcastle-upon-Tyne
England, UK
Net: www.schin.ncl.ac.uk
Phone: (0191) 256 3170
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