Missed the boat with Records Access?

There are 'delights' of being behind the times with 'IT'. But that is followed by the pain, challenge and frustration of trying to 'catch-up'.

And the NHS is always 'catching-up'!

In a reflective mood I am considering what I need to offer patients this year to make their lives (and mine) easier, safer and healthier. What can I do with the information I hold in trust, with the relationships I have spent so long developing and the clever opportunities that an 'on-line' world opens up?

The easy answer is to follow the innovators and evangelists on opening up records to patients - 'do what I am doing and your problems will be solved'. Or I could follow the bulk of my professional colleagues - 'I am far too busy doing the basic work 11 hours a day in General Practice to take on anything else'.

But perhaps there is a 'third-way' (with apologies to multi-millionaire Tony Blair)? To follow my instincts, trust my knowledge of my patients and my record system and pursue a local pathway to improve little bits of my Health Service provision and interaction - irrespective of National policy, perceived wisdom and the next wave of 'targets'....

And my area for attention may just 'leap-frog' the interest and expectation in Records Access for this year. E-mail is 'old' hat, social media is inappropriate, PCs are dated technology - but 'bite-sized' direct secure messaging may hit the spot!
So how and why have I come round to this view? Observing some of the trends and expectation across all age groups - our society is advancing using smaller and smaller 'parcels' of relevant but fleeting 'information' to make decisions and manage life, often through mobile devices. Who has the time, interest or inclination to 'wade' through long and complex documents to find a 'nub' of crucial information? Ask yourself, when did you last read through the T&C of a software update - or do you just press the 'accept' button and proceed?

In my world THIS is the way forward to share clinical data, recommendations, communication and interaction 'on-line' with an increasing proportion of my patients. It could be done via a medium of their choice (for inclusivity), text, e-mail, letter secure messaging - who knows. It will involve small discrete 'parcels' that are of immediate relevance - the patients can do what they want with it - dismiss in seconds, store or collate - the choice is open and free. Results, advice, updates, reminders, letters, prompts, warnings from the practice - and as we develop functionality comments, suggestions, status reports, questions, values and observations from patients and carers back to us.

Am I on the 'right' lines - who knows?

But I suspect I am not the only one thinking beyond Records Access...

PS

A year of on-line GP practice services for patients

My surgery has been offering ‘on-line’ interaction with patients since 2006. We started with medication requesting and appointment booking, and more recently added access to medical records in November 2011. What follows is a summary of the activity during 2012.

Successful logins	8745
New patients registered for service	227
Appointments booked	2018
Appointments cancelled	591
Repeat medication requests	2468
Address detail change	226
Medical record viewed	115

So what are my conclusions at the end of a year that has seen a significant rise in political interest over ‘on-line’ GP services for patients?

• With a practice list size of 9000 and 6 years of on-line service behind us, we still have an average of less than one on-line interaction per registered patient.
• ‘Transactions’ at the convenience of patients dominate the activity.
• Medical record viewing remains at a very low level without active clinician promotion.
• There is significant potential to increase on-line activity and relieve telephone and front desk pressure with routine tasks such as repeat medication requests and GP appointment booking.

We do not know the age/sex breakdown of service users – this could be informative.

We are uncertain how we compare with other practices

We have not researched the barriers to use by patients

Medical record viewing has not been a major challenge or workload in the previous year.

So – ‘more of the same’, or ‘must do better’?

For serious consideration in 2013:

• Offering nursing and ‘task specific’ appointments
• Advertise the appointment and medication services more actively
• Target specific individuals for Record Access and test result notification
• Press for better activity reporting from system supplier

Happy New (Patient on-line) Year!

PS