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Patients to be able to edit GP records 'far sooner' than expected

Patients will be able to edit and access their complete medical record ‘far sooner’ than many people expected, vice-chair of the National Association of Primary Care Dr Charles Alessi has said.

Dr Alessi told an audience at the 2014 Best Practice conference in Birmingham that the changes were inevitable, and that they were essential if the NHS is to successfully convince patients to manage more of their own care,

It follow similar comments by NHS England officials earlier this year, but Dr Alessi said that this is likely to happen sooner than expected.

He also claimed that GPs are contributing to a ‘culture of dependency’, albeit for good reasons, that will need to change.

Dr Alessi told the conference: ‘As of next March, we’ll all have access to our medical records. I think we should really be proud of the fact that, as of March, I will now have the right to ask my GP to view my medical record.’

But he added: ‘I won’t be able to know the things I really need to know, which is how to help myself, manage myself.

‘I think we’ve got a way to go to deliver access to medical records, but that’s going to happen far sooner than we realise… because the only way we’re going to get people more involved in delivering their own healthcare is by giving people permission not only to access their record but actually to write in their own record.’

He said there would need to be audit trails to prevent people from inappropriately changing their records, but he added: ‘The whole basis of the relationship is going to change.’

Dr Alessi also argued that, as part of the personalisation of care, GPs should expect more metrics on things like patient wellness to be introduced by local authorities to ‘hold healthcare to account’.

But he added this would also require patients to take responsibility for their own health, and said GPs had been contributing to a ‘culture of dependency’ by telling patients to return if they were worried about their symptoms.

Dr Alessi said: ‘We always say to somebody with a fever, or a minor complaint, “if you’re worried, come back”.

‘We almost have developed a culture of dependency, for good reasons, not missing important conditions like meningitis and developing conditions.’

In April this year, Beverly Bryant, NHS England director of strategic systems and technology, said patients being able to add to GP records was a ‘basic building block’ of what they were trying to achieve.

Readers' comments (26)

  • Dr Alessi:
    1. Safety netting is not a "culture of dependency"-it is about safety. The patient is not the clinical expert. Come and sit in with me and I will teach you how to do a consultation with a patient. You can take notes if you like.
    2. Notes access-this is again fine BUT there must be appropriate safeguards in place for many eventualities eg safeguarding issues, aggressive/dangerous patients etc. Again, I can educate you on these if you like-consider these scenarios a bit like the MRCGP exam.

    And finally remember, you do not have a monopoly on knowledge either so consider listening to your colleagues wisdom?

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  • Observe as your clinical notes become meaningless through self censorship.

    Notes are made to aid the Dr for the benefit of their patient. this won't improve care, it will just make notes less useful for the people who rely on them to do their job.

    I dispair ...as I have done so many times over the past few years about what has happened and contiues to unfold in the destruction of the independence of my profession

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  • Just checking to see if today is yet another April 1st on the calendar. We seem to be averaging at least one April 1st headline every week presently. Please,please tell me it is indeed another April 1st joke.......

    No, well I cannot get out of this profession quick enough then.

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  • I assume Dr Alessi has some evidence this improves patient care? Not just satisfaction but also the clinical out come. And the expected benefit will out weight the millions (?billions) which will have to be spent on IT and legal resources as well as reduction doctor's clinical time?

    He must be hiding this evidence well as I've not seen any.

    Unfortunately there will be knee jerk "it's a good idea" "whats GPs hiding if they wont allow access" reaction from narrow visioned patients to force this idiotic waste of an idea push through. Just like the billions wasted on Dersi centres.

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  • Medical records which the patient can edit and delete things they don't want, are worthless.
    There will be no point in making records any more.
    My head hurts from banging it against the wall at the endless tide of bonkers ideas from these self appointed "leaders" who can't stop trying to out-meddle each other.

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  • The lunatic have taken over the asylum and are running amok.

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  • where do you get these messed up leaders from ,,, i think probably we are the only country in world where patients can edit their own records... we probably should export some of these leaders allover the world... lol

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  • Dr Alessi, you have access already and have done for many years, just not through the high risk internet. It's worrying if you are vice-chair of NAPC and are either unaware of this or have not realised how you might be misconstrued with statements such as reported above. Amendments can be added to the written record if patient disagrees but the actual record should not be changed or it becomes worthless. I don't understand what you think will be achieved by this to make it worth the risk.
    What about hospital records? (You have been quoted as saying "complete medical record")

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  • And there we open the gates of heavens for all wanting to colour and embellish their records for insurance and other purposes.
    A bit of clarity would be helpful on 'Edit' - the matter and range of editing possible
    As far as accessibility of records is concerned - Was there ever any restriction on this? My patients could always ask to see their records so what's the big deal?

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  • This is actually terrifying. Exactly what information will patients be looking to edit? Where does this leave us medic-legally if patients have access to alter our notes? Medical records are a report of the information and assessment a healthcare professional attains through history and examination. By editing them, they become an inaccurate portrayal of the healthcare professional's findings given the information available to them. Access to records fine but editing them? Why ? Safeguards against tampering with information are paramount.

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  • they are not the patient's notes. They are the doctor's notes made about the patient. I can understand patients wanting to see them but notes would be more accurate and informative if this was not allowed. Surely the patient being able to amend them in any way is ludicrous. Make additions to the text perhaps but not change what another has written, add or delete diagnoses. any change they make must surely be pending until approved by their doctor but this is more admin and what's the point?

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  • just who are medical records for?? personally they are a professional record of what has happened in the consultation along with facts from examination and opinions as a Dr. These form part of a medicolegal record which may have to stand up as evidence on court. If all and sundry can comment and edit these records I could not longer stand by them and would have to start collecting records of my own on a different system. Maddness

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  • What is the point of this??

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  • If it's hasn't been documented it hasn't been done. So if the patient decides to delete the notes what happens, this must be illegal surely. Ridiculous! !!

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  • Transparency of information and patient empowerment is evidently very distressing for GPs.

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  • Dear All,
    May I reassure you. Patients "editing" their own records is self evidently wrong and I will not let it happen. Would Barclays allow me to edit my bank statement?
    Patients will of course be able to offer their own CONTRIBUTIONS to their records but these will need to be explicitly flagged as such. They may also REQUEST that changes be made to pre-existing entries (just as they can now) but they will never have the right to edit entries made by others.
    I write this as the Chairman of the GPC IT Committee.
    Regards
    Dr Paul Cundy

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  • why does alessi say it is inevitable?
    who does he think he represents in his pompous arrogance?
    please resign

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  • What's the issue as long as there is an audit trail to show all versions of the notes and who has made what changes?

    My notes are full of mistakes, inaccuracies and say I have allergies I don't, and don't mention allergies I do have. They say I take drugs I don't, and don't mention drugs I do take. They say I have diseases I don't have and don't mention diseases I do have. How is this inaccurate reflection of reality beneficial to patients?

    Patients with LTCs are the clinical experts on the management of their own diseases. I know loads more about the my diseases than the doctors I consult. Consultations are a two-way process. Ticking a QOF point check box once a year and correctly passing a few multiple choice questions to score CPD points doesn't an "expert" make.

    Time to start working with patients and stop patronising patients. No notes about us without us.

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  • To the anonymous manager and 'other health professional'.

    Professionals are regulated by codes of conduct. Since patients are not, and given the increasing frequency of complaints, and the fact that hitherto the medical record has formed part of our defence, it is naive to think this would be received well by the medical community.

    If it's being patronised that concerns you, 'other health professional'.

    'no notes about we without me'. No actually, its 'no decisions about me without me', but that needn't involve redacting your medical record.

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  • allesi who are you????

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  • Dear Paul (Cundy), I'm sorry but I am not at all reassured by your comments. I don't have a problem with patients requesting changes to notes, as they do at present. The merit behind any such request can be assessed on a case by case basis, but you also write "Patients will of course be able to offer their own CONTRIBUTIONS to their records but these will need to be explicitly flagged as such." I'm sorry, but this is complete madness. You must surely be aware of the style of some of the entries we are likely to see on our screens, cluttering up the useful information that HCPs have entered. Assimilating all the important information in the space of 10 mins as a locum GP is hard enough, without having to wade through patient entries, which may well be unreliable, subjective and even offensive. Please could you reassess your support for this move. Thank you. Dr John Pike (former member of RCGP IT specialist group and occasional attender at JCG meetings).

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  • "But he added: ‘I won’t be able to know the things I really need to know, which is how to help myself, manage myself."

    but they don't want to manage themselves they want the magic pill to do what ever they want.

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  • so, patients will be able to change medical records

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  • even if it's medicolegally clear which are the doctors' untampered records and which are the patients' own comments, this will still cause major problems as the doctor will need to extract, code and possibly action any information the patient provides as it will now form part of the medical record.
    this will be another source of "inflow" when we're already drowning in information from other healthcare providers and myriad people who feel the doctor "should be informed" in order to cover themselves or because they have erroneous health beliefs. And that's before email consultations become compulsory.
    But we've all had the equivalent of green ink letters from a few patients, and social media have shown how easy it is for people to rant on and great length, mistakenly and/or abusively with very little effort.
    I haven't got the time to read this but if there is one tiny nugget of clinical relevance that gets missed in this morass, I will no doubt be told that I have been negligent.
    I wish our "leaders" practised in the real world and had to live with the consequences of their actions

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  • Here's a medical record of the future. I've included only the bits you can rely on.

    " "

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  • There is a place for an IT platform where patients can access path results, track referrals, etc. In short, this should reduce our workload but ONLY if it is a completely separate system from our medical records. In other words, they need to know their GFR is satisfactory and not 70.

    But what has been suggested in this article is a joke. It's a good thing it wasn't in place in 2012 or some of Dr Alessi's patients may have documented their disgust at being ejected from the practice list

    http://www.pulsetoday.co.uk/gp-commissioning-leaders-practice-deregistered-elderly-patients-for-financial-reasons/14062588.article#.VEvR6DgtBjo

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