Thursday, 29 May 2008

Patient records

I received this email yesterday from Dr Chris Martin from Xenva.


Reading Holway’s HotViews today reminded me of a question I have long wanted to ask.

Why did the NHS choose what appears to be a monolithic and closed private architecture for their patient records system? There are internet based systems such as WebEx and Facebook which allow millions of records to be stored, accessed and maintained on a more open system, standardized architecture. Encryption and security software and systems exist that are good enough for financial systems where again internet architecture is used as a backbone for internet banking. Recent incidents have demonstrated that centralised monolithic systems are more prone to gross breaches of security and data loss than distributed web based systems.

None of this is new, yet the public sector seems to adopt a completely different procurement and architecture solution to the rest of the world – why? What are the benefits?

Best regards


Chris’ note coincided with an excellent article in Ovum’s StraightTalk by Georgina O’Toole and Cornelia Wels-Maug – The fight for patients’ records . I really do commend you to read it in full.

Basically, it was occasioned by the release in the US of Google Health which allows patients to archive their medical records on Google’s extensive data centres. The service (like most of the stuff we get from Google – eg Blogspot and Feedburner which bring you Holway’s HotViews) is FREE; both to the patient and GP/hospital. Google retains the right to 'sell' the data for research purposes. (Those in the UK with long memories might well immediately recall VAMP which promised GPs free PCs in return for access to medical records). Google is not alone as Microsoft has launched a similar service called Health Vault.

Ovum makes the point “In the UK, services like Google Health would compete with portals such as England's NHS Choices (which enables patients to find information on local health services, medical conditions, treatments and healthy living) and Wales's My Health Online. Although patients may well want to supplement the patient record that is held by their GP or hospital with a Google Health or Microsoft Health Vault record, we do not envisage clinicians ceding control of full patient records to the patient in the foreseeable future.”

Ovum concludes “it remains to be seen who can address the underlying fears surrounding abuse of data protection better - a state agency or private enterprises?”

I am reminded of my own doctor who told me some years ago to insist that I physically took my X-Ray from the hospital to his surgery as that would be the best way to ensure it didn’t get lost (this was before the digital X-ray system was implemented) Personally I’d much rather have my medical records on Google than on the NHS System. I know that sounds strange – but I entrust a huge amount of very personal data to Google already! So far I haven’t had any problems.

And, of course, as Dr Chris Martin says (above) that is before the HUGE cost saving such a system could provide.

Your views, as ever, gratefully received.

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