Viewpoint: My Healthcare under my Control, with my Consent, for my Benefit.

 

I welcome the recent White Paper -  ‘Equity and excellence: Liberating the NHS’ -  issued by Andrew Lansley, Health Secretary, setting out some worthy and technically achievable ambitions for NHS patients justifying, at least in part, the huge cost of the necessary computerising of patient records.

 

Allowing the patient a choice of service providers will persistently identify successful and failing healthcare providers on quality of frontline ‘service’ rather than the admin-hungry ‘targets’ currently in place.

 

Over a year ago I wrote ‘Have the Tories found the answer to NHS IT?’ in which I set out what I, as a citizen, patient, parent, employer, carer, wanted the NHS to give me as the best return on my NI contributions. To bring it up to date, I should change ‘Tories’ to ‘Coalition Government’ but not much else.

 

A healthy society is good for citizens, business and the nation (tax payer), so that old cliché ‘prevention is better than cure’ is even more relevant given the dire financial straits in which we find ourselves today.

 

Whereas the White Paper focuses on NHS patients, the longer term opportunity for this initiative is to provide the ability for the patient to store a synchronised copy of their NHS medical record to which they can choose to allow access or delegate responsibility to their GP/parent/child/carer. The individual can choose to add other relevant data input from non-NHS health related suppliers (private dentists, chiropractors, sports trainers, dieticians etc.) providing an accessible holistic personal health record with the ability for the individual to share relevant medical information in other trusted relationships such as employment or insurance.

 

My recent personal experience with my aged father is that it is impossible to get different specialists (Dermatology – Nephrology) within a single hospital to cooperate (“Not my department”) and share information, let alone the GP, PCT, Consultant, Carers, Social Services, Pharmacist, etc.

 

I am repeatedly asked, “What’s wrong with him?” “Has he had any operations?” “What medication is he on?” all of which the same hospital has diagnosed, performed and prescribed. Why are they asking me? Why are they scribbling it unintelligibly on little pieces of coloured card? And what information are they relying on from an 85 year old with dementia when I am unable to accompany him to the hospital?
I then push him in his wheelchair, clutching a handwritten prescription, to the pharmacy to join a long queue to be told to come back in half an hour.

 

Confusion and error

 

All this confusion, duplication, opportunity for error and time wasting of valuable medical expertise would be resolved with a simple keyboard/voice/touch screen interface to the patient record under strict access control. This is not new technology – they have been using it in restaurants for years!

 

Legal compliance, security and privacy are major issues that must be addressed.
 According to the Information Commissioner's Office (ICO) earlier this year:
“. . . the NHS is responsible for the highest number of serious data breaches of any UK organisation since the end of 2007. . . Most of the breaches (113) were the result of stolen data or hardware, followed by 82 cases of lost data or hardware.”

 

The solution is ‘access control to encrypted data in the Cloud’ with an audit trail of who accessed what data, when and why. To achieve this, the NHS needs to provide:

The outcome of such a structure will be to improve the accuracy and controlled access to data with the express permission of the patient who will be able to exercise the ‘choices’ described in the White Paper whilst substantially reducing the administration time and cost of  patient data collection, maintenance and sharing in compliance with the Data Protection Act 1998. The structure can then be extended to NHS procurement.

 

Now, let’s apply these same principles and outcomes to Education and Employment!