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Article: English Physicians Plan To Boycott Patient Health Record Database

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alborg Geeked [8-|] Posted: 02-15-2008 2:20 AM

Anyone know how this has ended up? Sure shows how government should move slowly when throwing money at unproven, expensive HIT schemes...

English Physicians Plan To Boycott Patient Health Record Database

Nearly two-thirds of family physicians in England plan to boycott the government's attempt to create a database of 50 million National Health Service patients' electronic health records, according to a poll by Medix, a health online research organization, the Guardian Unlimited reports.

The poll of more than 1,000 physicians found that:

  • 75% of respondents believe medical records would be less secure if they are added to a database that could be accessed by NHS and social services staff throughout England;
  • 50% believe the records would be vulnerable to hackers and unauthorized users by officials outside of the NHS;
  • 25% said they are concerned about bribery or blackmail by people with access to the database; and
  • 21% said they thought social services staff would not adhere to confidentiality rules.

The survey also found that 59% of respondents said they are unwilling to upload EHRs without explicit patient consent (Carvel, Guardian Unlimited, 11/20).

NHS' "policy is that patients should be deemed to have given implied consent to sharing their health care information between relevant clinicians unless they specifically opt-out," according to a letter last year by the British Medical Association. BMA opposes the patient consent policy and its letter urged physicians to inform patients of the electronic data sharing "so they can make an informed choice of how they want their information to be shared" (iHealthBeat, 11/17/06).

The database is part of a £12.4 billion, or $25.6 billion, project to modernize the NHS' IT systems. The survey found that 70% of general practitioners and hospital doctors believe the program is not a good use for NHS resources, and only 1% of respondents said the program's progress is good or excellent (Guardian Unlimited, 11/20).

Al Borges, M.D.

  Oncologist in a Small Group Practice in Virginia

  My website URL: http://msofficeemrproject.com/

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The reason for this data-security concern is a catalog of several very serious data-loss episodes in the UK.

  • The biggest in November 2007 was the loss of personal and bank account data for about 25 million households by the [wikipedia:HMRC] (about half the UK Population) -- families or guardians receiving some form of child benefit. These were a couple of unencrypted CD-disks sent between offices in internal mail. Despite local offices being searched, police involvement, a $40,000 reward, the various Govt. offices trying to blame the third-party courier managing the internal mail, the disks have still not been located. While the Govt. stress that there "is no evidence that the data has been used fraudulently", most commentators suspect that as children reach 18 -- the age at which they can sign for credit -- their identity will be hijacked and used for credit card fraud.
  • Moving onto December 2007, 6,000 Northern Ireland (part of the UK) drivers details go missing in the post on route to another Govt. agency. This really reinforced the apparent standard govt. practice of routinely sending unencrypted data in the post.
  • Still in December 2007 a northern Primary Care Trust sent financial details of 2,000 staff to 4 different companies tendering for work with the Health Authority. This in breach of UK data protection laws.
  • The end result? No government resignations, but plenty of political fall-out with on-going voter mistrust of the (very odd, psychologically flawed) Brown Labour government and its continuing mismanagement of our economy.

There are many more equally incompetent cases of lost or missing data in the UK but we're not alone. The Register reports on J.C.Penny, T.J.Maxx, Marshalls estimating that 650,000 customer's data is leaked with these cases alone.

There is also some general mistrust of government by the GP -- (General Practictioner is a Family Physician)

Their trade body the British Medical Association last year negotiated a (brilliant & lucrative) new GP contract which sees most doctors earning about £100,000.00 per year, many earning much more.

Just two examples: GPs get a bonus to meet a target for patients to get an appointment within 48 hours. Note that virtually all GPs meet this target. When you then try to book an advance appointment for something really not serious, but to suit your own schedule -- you're told to call back "within" 48-hours of when you want the appointment. Brilliant. Cunning, but brilliant.

9 out of 10 Doctors gave up out-of-hours care shifting this burden back to the local health authority to employ private firms who wanted to specialize in this area. The GP gave up 6% of their income in exchange of no out-of-hours service. In practice more patients call ER rather than trying to call and then wait for an out-of-hours Doctor. We therefore have minor ailments competing with trauma-cases in the ER alongside the drunken detritus of society brought in by the Police or Emergency Services following street-fights or domestic disputes.

An aside: My last GP appointment was over 1-hour late. I was seriously unimpressed and made clear my views on their p__-poor standard of customer care. 

So.

  1. Doctors have issues with the UK Government over attempts to force change on their lucrative contract. A contract which is already signed and a done deal. For example, the Govt. is forcing through increased opening hours after work and Saturday mornings.
  2. Patients have issues with GPs generally for either poorer service or reduced access to FP medicine and problems getting appointments.
  3. The UK population has a good reason to distrust the Governments ability to hold personal data confidential or for that matter to manage any serious IT project.
  4. Is the Doctor or the Practice liable if patient data is leaked?

Just my $0.02 as a infrequent consumer of (free) GP services in the UK.

Nick 

Nick Harrington email me or Skype: nickharrington emrupdate.com
If I have seen further it is by standing on the shoulders of Giants" Sir Isaac Newton 1676

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Just a bit of extra info that may or may not be of interest, 56% of primary care givers in England and Wales use the same EMR, in 2007 more than 45 million health records were available to the users of that EMR.

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I have many articles posted to the blog relative to the NHS and their record issues...you can read more here if you like, inlcuding the story about the loss of the CDs, which was totally a human error and someone not wanting to spend a few dimes...

http://ducknetweb.blogspot.com/search?q=nhs+records

Barbara Duck      Ducknet Services       TabletKiosk Sales Information

Blog: http://ducknetweb.blogspot.com/

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Skype Address: Ducknetservices     Phone: 714-898-1917   Email:  barbaraduck@ducknet.net

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bigbadwolf:

Just a bit of extra info that may or may not be of interest, 56% of primary care givers in England and Wales use the same EMR, in 2007 more than 45 million health records were available to the users of that EMR.

 

Which one is it ?

Is it free ?

Made by the .gov ?

 

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Hi Dr Murdoch,   The EMR I mention is not free, but if I’m not mistaken it’s possible for each practice to claim as much as 100% of this investment back.

I don’t really want to give any EMR here a free advertisement, I’m sure a little digging around on the UK NHS site lead to the list of approved suppliers for England and Wales. As I know Dr M you’re not afraid to do a bit of searching, the same EMR vendor is also involved in the NHS Connecting for Health (CfH) Common User Interface (CUI) programme, I hope that give you a clue to this particular vendor, I think that narrows the choice down to two.

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