Perhaps I should also introduce myself, I am a Consultant Anaesthetist and Clinical Lead for eHealth in Scotland.

I agree with Jon that record access is a means to an end rather than an end in itself. But, at the moment, anyone with a longterm condition manages it themselves 99% o the time even if it's very complex. And yet we have a health system that doesn't find it illogical to starve them of information, giving it instead to those who do 1% o the work. We need to come to our senses!

Once you are critically ill you want the right diagnosis, right treatment and no avoidable harm.

If you have co-morbidities e.g. now you have pneumonia on top of COPD, diabetes, kidney disease, you NEED the hospital docs to know all the facts, NOW. Right now they don't - especially at night - they ask you the same stuff about your previous health, your meds, you forget you are allergic to penicillin cos you are coughing so much.

This process would allow you to say - open the PC doc, I'll give you my user name and password, all you need to know is there on my Doc's system - carry on. So then the docs don't give you penicillin and kill you.

Brilliant, revolutionary, gives "Power to the Patient" - saves huge amount of time, and harm - please - we need this yesterday

Expert patients with chronic conditions have frequently found coping strategies, so that their assessment of a 'bad' pain may be different from that of a person with a first recent flare-up of something they do not fully understand yet; similarly clinicians may also use jargon and a grading system different from each other. Simplistic examples, but highlighting the challenges of multiple inputs to the same record.

Two possible ways to reduce misunderstanding - one - clearly identify and attribute each type of input to a type of person (as well as individual persona for audit purposes, or do an initial exercise to 'educate' the system to understand what each input person might mean by what they say (like an audio transcribing system).

Would this be feasible?

I have set up an online care record which I have populated with records from my GP, Hospital, (Social services – if I had one) etc. I now can co-ordinate my care in a virtual team environment. No decision about me made in avoidable ignorance.

I tend to agree with Jon , we should keep it simple to begin with - book appointments, agree to care plans, re order medications. A useful thing could be to list the clinicians who are involved in your care and what they can provide for you ( a personalised service directory) with contact details.

Interesting idea by LP on personal service directory -- and something that should be entirely doable through some sub-set of spine acess services or even NHS Mail active directory. Be even more useful if it showed pic of the person and a professional profile.

But am convinced that greatest value would be in enabling people to do things they want to -- like have an online consult or discussion with one of their care providers. And this surely isn't primarily a technology problem.