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GPs go forth

This goes way beyond the usual SARSache

Copperfield

I’m not usually prone to Chicken-Licken levels of angsty clucking. Yet somehow, I find myself confidently predicting that the sky is going to fall on our heads.

And it’s all because of my latest obsession. Surprisingly, given that primary care computing is high up on my list of Special Disinterests, I’ve become fixated on our next great digital leap forward, as of 1/4/2020. Make a note of the date in your diary, then chuck the rest of your diary away. Because, thereafter, we’re all doomed.

What’s agitating me is not the fact that patients will be able to ‘add their own information’ to the records, risible though that is – presumably, there will just be a tab in ‘journal’ where punters can make irrelevant contributions, like toddlers being distracted by some colouring while the adults get on with the serious conversation

No, the actual cause of Armageddon will be this: from April 2020, all patients will have online access to their full records.

Your initial reaction may be one of unrestrained joy. After all, one of the current torments in general practice is SARs.

In the good old days, that stood for nothing more troublesome than the often-fatal severe acute respiratory syndrome. Nowadays, it’s much more serious: subject access requests. As we all know, this is a complete SARSache, not least because of the unfunded workload and hassle involved in checking, copying and transmitting the patient record.

But from April 2020, you can delegate the job to the patient, who can access, annotate, digest and churn out their records as the whim takes them. Job done.

Punters can add contributions, like toddlers distracted by some colouring

Except, that is, for the teensy problem of redacting third-party information. You know, those buried gems revealing, say, information given to us in confidence by a named family member, the drug habits of a partner identified in a 30-page safeguarding report or the current address of a wife living in what, until you inadvertently revealed it, was a refuge from her physically abusive husband.

These things are hard enough to spot and redact when you’re prompted to look. But with open access, patients will see it all and we’ll have no idea they’re even looking.

How do we solve this problem? Simple. We just have to proactively seek and destroy all legacy third-party information in every existing set of records, within the next three months.

And then regularly update the process, in case one of the agencies able to make a note entry – namely everyone and their dog – has added something dodgy since you last looked. Otherwise, we face ruinous fines. So by ‘simple’, I mean crushingly impossible.

Why, then, when the sky really is so clearly about to fall in, is no one making an almighty noise about this?

Is it because of the rider in the contract that full online access is subject to existing safeguards and system functionality? Those safeguards don’t exist and that system cannot function. So maybe it was just an acorn after all, and I’m making a stupid clucking fuss. It would be nice for someone to let us know, though. Preferably in the next three months.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield

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Readers' comments (5)

  • Redaction as required is not humanly possible so leave it to the computers to redact all names not the patient and relationship words. That’s what we do with SARs. As long as you put a recognised system in place you have done your duty. The problem is anyone with a brain can read between the lines and work out what was said and by whom. So it will always be impossible to prevent harm. But we will have what was required legally so it is not our problem any more.

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  • and when will EMIS/System One / An Other deliver this wonderful bit of software??

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  • Jeez - what about those entries like "To whomever sees this patient next - his wife reports he's drinking 4 bottles of whisky a week but would kill her if he knew she had disclosed this" - can see all sorts of issues ahead. Not to mention the entries from years back when we were less careful with language... "clearly histrionic and putting on a good show of back pain" anyone?

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  • Who is the Data Controller?
    It is NOT the GP Practice any more, because the data is held elsewhere by the CCG/devolved nation, who controls access.
    It is THEIR responsibility to check the notes before allowing access!
    At last, something GPs can bless IT for!!

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  • This is clearly nuts, and the law of unintended consequence will apply. Who does this serve? There is already a mechanism to view your records if you wish, and it’s the request that triggers our response. This is granting the more eccentric 1% of your list the right to thumb through the record unchallenged at their leisure just for kicks. Complaints WILL ensue. Consultations WILL be demanded to explain what “overlay” is. It’s yet another example of the devalued status GPs now enjoy in a post-truth world. No wonder we are fleeing abroad t9 saner systems. Like me!

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