@AC 0907

I'm not a fanboi. That implies I'm blindly devoted to a concept because of who espouses it.

I simply have a carefully considered opinion about the relative merits of the SCR scheme that doesn't rely on the standard straw-men ("the data will be wrong becasue it's input by minimum wages trained baboons", "it means I'll be forced to carry ID wherever I go", "insurance companies will steal my medicalz!").

I find most of that type of reasoning spurious. I don't think the implementation of SCR is perfect by a long shot, but it's better than whhatever my GP must use currently, which presumably involves random number generation.

So yes, I downvote posts where I don't think the issue is considered in a balanced way when held up against reasoning like the above, or where someone attacks a poster for the manner in which they post, or where they are just wrong. That's the point, and you are free to do the same.

A note on logical fallacies

To quote wikipedia*:

"A straw man argument is an informal fallacy based on misrepresentation of an opponent's position".

I would suggest that worries about data accuracy and veracity, and the leaking of that information to third parties are both legitimate concerns that do not appear to be adequately guarded against. I can't see these concerns being put forward in such a way as to misrepresent the views of anyone here. As such, these are not straw man arguments.

A famous example of a straw-man is to claim that since Hitler was a vegetarian, then vegetarians must be fascists.

I would also like to point out that nobody here would appear to be claiming that this system would lead to people having to carry ID. As such, your argument itself ironically constitutes an example of the straw man fallacy.

I have to agree with you on one point, however - you are not a 'fanboi'. Such name-calling constitutes another common logical fallacy, the 'ad hominem' attack.

*Yes yes, I know everything written on wikipedia is lies, etc. etc.

Re: the SCR scheme is very vague

I agree.

The initial upload will be medication in the last 6 months, adverse reactions and allergies.

The "enrichment" phase (no further notification tot he patient) will include diagnoses and other information uploaded at every consultation - or a set of data nationally agreed or decided by your GP practice - either in consultation with your GP (I can see surgeries running *very* late!) or with a notice in the waiting room.

Following that, the next step is to include all correspondence - A&E letters, hospital discharge letters (the quality of these would ensure that anyone relying on them for information would be putting themselves and patient at risk - unless there is very serious effort to improve them everywhere: no sign of this at present).

In Scotland, they have the ECR (Emergency Care Record) which is - **and will remain** an upload of medication and adverse reactions/allergies only.

Cheaper, more likely to be accurate (apart from lacking secondary care medication such as chemotherapy) and very useful for medication reconciliation (making sure the hospital doesn't give you something which has serious interactions with your regular medication).

I'll say it again: if you have serious allergies, major conditions or multiple medication, invest in Medic Alert : no-one is going to stop resuscitating you to check whether you have a SCR.

If you are elderly, confused, multiple medication and frequent admissions, a SCR might possibly be of benefit - but you or your carer could ask for a summary print out from your GP practice.

Even if you have a SCR, the evidence so far appears to be that, even in Hampshire where there has been a similar upload of patient records since 2004, the number of times these records are accessed by urgent care services is remarkably low: so is the SCR (as opposed to the ECR) really value for money?

Security and large databases are contradictions in terms: and both Alex Salmon and Gordon Brown are known to have had their ECRs accessed ilegitimately: they must be glad they didn't have enriched SCRs!

..how are we identified...?

If I'm in a car crash 300 miles from home, unconscious and alone how will they get at my medical records? How will they know they are looking at the right one?..

Well, the nurse at my mother's surgery was rattling on about blood test results etc to her the other week and fortunately my sister was there with her and detected a rat... poked her nose around to see the screen to find a different patient's records there!!! OOPS , wrong patient and records... and that is in her OWN doctor's surgery..

I think I would rather take my chances being treated as 'we do not know his records so better take care' than 'according to the records this chap has X and Y wrong with him, use these drugs....' and it is the wrong medical records they are looking at... !

@Seareach

In "...could buy in proven cloud based technology..." you missed out a couple of words. Revised "...could buy in proven TO FAIL cloud based technology...".

Or have you completely ignored all the stories on the privacy breaches in those systems?

I'm with No2Id on this - just get rid of this costly privacy-invading pile of crap.

Standards, we don't need no stinkin' standards!

"Google for one does NOT reach NHS security standards which is why the NHS uses NHSMail and not GMail."

And the NHSMail system is so locked down and broken, that those in the NHS use Hotmail.

@Mike JVX

I suppose the first part I don't like is the fact that it is opt-out - and that is made needlessly inconvenient. Let it be opt-in, and then people like yourself can sign up and be the canaries the rest of us can watch and see if it is safe...

It seems everything in Government these days needs to be "monetised" - notice the selling with minimal safeguards of DVLC data which we, by law, are forced to give. (As an aside, if I were a scam artist I would *love* to have the details of the 30k or so who signed up for ID cards.)

How long I wonder before health records are monetised to pharma or insurance companies?

So if you want to opt-in to be a canary, and wonder why your insurance premia suddenly go up, or find that you are "volunteered" to take part in medical trials, feel free to keep on taking the pills. (See - ad hominem attacks easily work both ways, and are just as unpleasant either way.)

@Mike JVX - Stop with the Scare Tactics

Tell me, are you some sort of shill for a company who has a nice lucrative contract for this system?

I got a letter from my local GPs office saying "We notice from your medical records that you have requested for your records not to be held on the shared electronic record" and pointing out that there is a local record that I also have to opt out from with an attached form so I could fill that in and drop it in (very helpful of them).

Also attached was a document (see the link below) basically trying to scare the reader into thinking "OMG if I don't have a summary car record I might be killed by someone in the NHS screwing up and not taking the basic precautions that they should!"

http://issuu.com/skybluemedicalgroup/docs/if-i-do-not-have-a-summary-record---patient-leafle

Well I don't have any allergies, on-going conditions or other medical problems that anyone needs to know about. If I did then, like my friend who is diabetic, I would carry a card in my wallet or an emergency bracelet/ dog-tag with the relevant details in, rather than having the people attending me have to a) look for some details in my wallet and *then* phone up/ log in to a computer system to hopefully find *MY* records and not someone else with the same name or, even worse, the records of someone else which have been incorrectly input by some minimum wage contract staff.

So, no thanks, I'm not going to be scared into submitting my details to something, even one which I will have "24 hour access to" in order to check it for errors (why should I have to validate *their* data input?) and I don't think that this will give me "peace of mind" when I'll be thinking "how secure is their system *really*?"

NO2ID's issues...

It's not the 'computerisation of patient data' that's the problem (I mean, have you seen the paperwork the keep at your local GP), it's 'keeping it all in one place' that's the problem. It introduces single point of failure problem - if it goes wrong, everyone suffers. It provides a single attack point for hackers / insurance companies / etc. It takes control of personal information out of the patient's hands entirely.

A much better solution is to have patient details stored at the GPs surgery and define a framework to allow other GPs, hospitals, A&E departments and so on to access the data. GPs would then be involved in the patients data access providing an extra level of control over the data.

If I had a penicillin allergy

I'd make damn sure I always wore a medicalert bracelet.

If I had an embarrassing health problem, such as an STI, it would be the business of my GP, and NOT a paramedic if I happen to get hit by a bus.

And seriously, do you think any qualified doctor would not be able to spot the rather obvious symptoms of COPD?

Add to this the fact that in most cases, people being admitted to hospital are fully conscious at the time and quite capable of giving their own medical history, there really does seem to be little point to this system, and you have to ask yourself whether the costs justify the perceived benefits.

@Skizz

Yes, I agree. I think your solution is reasonable. However, I think it would become unmanagable and might require some sort of roving regional IT team, or maybe someone in each surgery with some responsibility for this (for standardisation, compliance, performance issues maybe?) and that could be a problem on its own.

I guess if I were the hypothetical patient here I wouldn't care whether the point the system failed was central or local to me, and the central model seems more robust to me.

My doctors...

...has been known to cut bits off me and inject me with things purely on my verbally-declared name and DoB.

If I am out driving, I will almost always have my wallet on me, which contains my driving licence, which has sufficient information to identify me. In fact, I almost always have my driving licence on me whereever I am. Now, at risk of inciting any "in our facist police state" or "papers, citizen" comments, I think there should be a requirement to carry ID when you drive like most EU states and (I believe) the USA. Mind you, I'm not averse to having to carry ID all the time.

However, I digress. Given the (relatively) low threshold for ID verification I have seen in the past, I would imagine that any ID you might be carrying, the registration details of your car (I assume some sort of accident scenario here, where the police would be present), or the PNC insurance database would probably be sufficient to locate my SCR.

Really?

I would suggest that it is those who are in support of this scheme who are constructing the 'straw man argument' that you speak of. IN the absence of a major accident, these records would appear to be of little use.

The one advantage I have been made aware of that the SCR may bring is the issue of medications and notes following patients when they are transferred from one hospital to another, e.g. to a tertiary centre for a major operation, often across PCT boundaries. Because of the mess most hospital systems are already in, there can be delays in getting things like x-rays transferred.

IMHO, this problem would be best tackled through better integration of systems between hospitals, without the need for long-term persistent data about patients. Proper digitisation of diagnostic data, such as x-rays and MRI scans, combined with an efficient pathway for one hospital to request this information from another. At present, this sort of request requires a call to a radiology department, and the hope that someone is available to find the appropriate prints, and send them through an internal post system, or courier.

It is worth noting that in these cases, the identity of the patient is known and it is the acute medical information that is important, not the patient's medical history from their GP, which is of little relevance.

@AC 0847

Blimey, what a refreshingly sensible opinion!

@Anonymous Coward

If you think that having lots of people having access to your medical records is so great, please post them here.

Oh, but you're anonymous...

@ Graham Marsden

While we are on the subject of critical thinking, thats what we call a 'false implication'.

Catch up old boy.

I suggest you have a read up on PACS with regard to digital transfer of radiological images. Actually, if you want a good example of how IT can work well in the healthcare setting, and how it can offer considerable benefits, you could do worse than to see how radiology departments across the country have introduced PACS with minimal fuss and without the drama that we see here...

@Anonymous Coward

Actually that's what we call "Taking the piss"...

Dear Mr Nigel 11

It has come to our attention that you have been treated in the past for high blood pressure. As such we are increasing your life insurance and car insurance premiums as we consider you to be a greater risk.

Yours sincerely,

The Big Insurance Company.

PS Still, you've got nothing to hide, so why should you worry?

errr....

You understand that you are supposed to declare pre-existing medical conditions if you are applying for life insurance don't you? I mean if you don't and then keel over you don't actually expect them to pay out?

I think insurance fraud is what it's called.