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Long wait for health records

The government has confirmed that we will need to be patient in waiting for patient care records. Health minister Mike O'Brien told Parliament that it would be 2014 or 2015 before all health trusts had properly deployed health record systems. Parts of the system are already up and running and a spokeswoman for Connecting for …

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Bassey
WTF?

Always wondered

How someone who can be SO incompetent as to put unencrypted confidential data on a laptop AND leave the damn thing on a bus can still be prescient enough to have made a note of the exact number of records and to what they pertain?

Michael 82
FAIL

if this is the system that my Doctors have just rolled out?

Then it will be 2014 or 2015 till I can book an appointment as its too damn slow for the receptionist?

qwertyuiop
FAIL

Not on laptop

@Always wondered

If they were ward notes (as stated) then they were probably on paper and not on a laptop. In either case, given that you know how many beds there are in the ward working out how many records have gone missing is hardly rocket science!

Adam Foxton
WTF?

@Bassey

Well, you could have a look at a local copy you made or have a look at another version of the CD or what have you- if they were actually _losing_ data rather than losing _copies_ of Data then that'd be far, far worse!

Still, as it'll apparently take "a couple of months" (according to my GP) to move my records a total of... ooh, about 65 miles this system can only be an improvement.

Anonymous Coward
Anonymous Coward

Our records were completely wrong

My wife and I found our Health centre records were 70% wrong!, and not in minor details either.

The errors only came to light when my wife had to visit a consultant, our GP attached a summary print out of her medical record to the consultants letter. When the consultant went through the summary record with my wife, she was surprised to learn that she had had a hysterectomy, (she hasn't). She had had a cancerous mole removed from her arm, (she hasn't) It went downhill from there.

After a great deal a buck passing and denial, we sat down with our local Health centre practice manager. We found around 70% of both our records were erroneous, items missing and items nothing to do with us had been added.

The practice manger said she could not understand it, Her best data entry person, (a retired midwife), had transcribed the records from the paper hospital letters and paper records. I said "What has that got to do with keyboard and data entry accuracy?"

When I asked how about double entry by two people or at least entry checking I got a blank stare.

It is not just a one time problem. The records should be constantly updated with the results of tests and hospital procedures. However this was not being done. We found digitised scans of consultants letters in our files, that had NOT been entered on our record database

The practice manager told us, that we were lucky, her practice was a lot better than many. She said the records of many people moving into the area and passed to her were very very bad!

I have had a look at the specification for the "paper thin" NHS system for GP's. It is very amateurish. The only requirement for Accuracy is : "The records shall be accurate" . There is no advice on the best way to ensure data entry accuracy. There are a set of database test diagnostics available. The only thing they test is that the codes used in the record fields are correct codes.

THERE IS NO CHECK ANYWHERE IN THE SYSTEM THAT THE PATIENTS RECORDS ARE ACCURATE. The patient is never normally asked to check their record.

That is why I have asked for my wife and my electronic records to be removed from the Heath Trust shared database.

Graham Bartlett
Flame

What am I missing?

Hang on a mo. It's cost a fortune, it's costing more to maintain, it's less accurate and it's not even fully working yet. In what way can this be described as better than the previous system?

Don't get me wrong, I'm all for my records being available on computer instead of relying on some dodgy scrap of paper in a filing cabinet. There's all sorts of good things you can do then, like automated prompts to the doctor based on symptoms to narrow down the possibilities, which is proven to work much better for oddball problems that most doctors would be unlikely to see often (if at all). Or statistical analysis of outcomes so that incompetent or plain evil doctors/nurses are more likely to be spotted early.

But I do want those records to be correct and to be in a database which works. Pretty much every company in the country went through precisely this exercise in the 80s or at worst in the early 90s, so it's not like it's something that's never been done before. All this shows is that the NHS is incapable of hiring competent managers.

Mary Hawking

ref What am I missing - and our records were wrong

What you are missing is the cradle-to-grave historical record, the complexity and fundamental fuzziness of the data being handled, the lack of any agreed language in which to handle it, the different record keeping needs of different organisations, the size of the workforce and the risk to business - and patients - when changing from one form of record keeping to a totally new - and alien - way of working.

GP records have been developed since the beginning of PCs in the early 1980s. The staff in a practice are stable (junior doctors move every 6 months) and the things a computer does easily and well reduces the workload for everyone.

Hospitals are much more complex, different departments have different needs, unlike GPs medical staff move to the patient (records difficult without affordable mobile devices), and without a good PAS, with a robust patient identifier, linking records for individual patients is hard.

The concept of being able to transfer electronic records electronically is relatively recent: in general practice, we now have GP2GP record transfer between two suppliers (EMIS and INPS): very good - but doesn't solve the problems of different practices recording things differently - or criteria for diagnosis changing over the years.

The original concept in NPfIT was that hospital record systems would absorb the local GP records - and the whole record would be able to be transferred to a different hospital intact: this dream didn't last long - and completely ignored the complexities of patient records.

I agree with the previous but 2 poster - a lot of medical records do contain inaccuracies - some from inaccuracies in the original letters dating back over the lifetime of the patient, some from transcription errors, some from mistaken identity (why do men want to give their sons their own name?) some from changes in terminology and diagnosis.

The article confuses three things: EPR systems in hospitals, the SCR (summary care record) and data security on portable media - whether paper or electronic: the security issues with EPRs not transferred to portable media may be even worse - but are totally different!

As regards sharing patient information appropriately for the care of the patient, why concentrate on monolithic single records?

Surely the old Thin Spine concept (records remain where generated and the spine enables location and viewing) is preferable?

How about a bit of interoperability instead of the destroy and replace current philosophy?

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