Patient access concerns voiced by GPC

GP leaders have said they are concerned giving patients access to their online record could risk their medical history being used against them, and may create more work for GPs having to explain medical terms to worried patients.

The BMA’s General Practitioner Committee on Thursday discussed the issues associated with the government’s announcement that all patients will have access to their GP medical record online by 2015.

Chairman Dr Laurence Buckman said the committee did not think giving patients access to their records was a bad idea.

However, he said the GPC did have significant concerns about a number of issues including security and ensuring patients were not coerced into sharing their records with a third party.

Dr Buckman said a variety of people - such as lawyers, employers or insurance companies - would be interested in seeing a person’s medical and could potentially use the information against them.

“There are a variety of abusive and inappropriate relationships where the information stored on someone else’s record is of interest to a third party,” he said.

“That doesn’t mean they shouldn’t have access, but we need a way of doing it so the patient is protected.”

The GPC was also worried about people reading something in their records which they did not understand and becoming alarmed. This would result in additional work for the practice as they would call for an explanation.

It would also mean doctors having to translate medical terms to make it appropriate for patients. He gave the example of miscarriages being called abortions in medical terms, when the word abortion meant a termination to members of the public.

“GPs experience it when patients come in with hospital letters and say ‘what on earth does that mean?’” he said.

“We need to do it in a way that helps patients understand what’s in their record and that needs very careful thinking about.”

Dr Buckman said any proposal for patients to be able to edit their own record would be “very concerning”.

“We’re happy for them to say ‘you have got this wrong’, but to edit online means there’s no control over what’s going in and out of the record which is potentially quite dangerous.”

Dr Chaand Nagpaul, the committee’s lead on IT issues, said people should remember that patients already had access to their paper records. The assumption was that the criteria for access to paper records would be the same for online. For example, access could be denied if it may cause the patient psychological harm.

He added that there were clear potential benefits for enabling some patients to have remote access to their records, but there was a need to “tread very carefully” and “think through the implications where there might be disadvantages for some patients.”

The process of putting forward these views to the Department of Health and NHS Connecting for Health had already begun, but was at a very early stage.

“We are in early dialogue, today’s debate has helped formulate a response that we will be feeding in,” he explained.