Drug Companies to Get Access to Medical Records

Debbie Williams

Blog, Monday 7th February 2011

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The issue of using patient data for secondary business use has been an area of concern for many, prompting some people to question its impact on patient confidentiality and privacy.

Last week, a new NHS computer system came under attack from privacy experts after it was revealed that the system would share the medical history of millions of patients with drug companies without seeking proper consent.

The system, the Secondary Uses Service (SUS), is part of the NHS’s National Programme for IT and significantly expands the amount of medical data that commercial and academic researchers can access. As the data is usually anonymised, patients are not asked for consent.

However, Dr Ian Brown of the Oxford Internet Institute said that NHS rules mean participants in research can be “trivially” re-identified, especially as some of the “anonymised” data also includes the unique NHS number for each patient. It has been suggested that these weak privacy policies could be illegal under European data protection laws.

Clearly, Trusts need to take patient confidentiality seriously and have an effective method for upholding privacy policies and for meeting legal guidelines.

With Ardentia’s Pseudonymisation tool, Trusts can safely undertake secondary use of patient data. The solution allows users to configure pseudonyms to be specific to an organisation, a group of users, or an individual, and ensures that only authorised personnel have access to identifiable data. By removing key identifiers that may associate a treatment pathway with a particular individual, Trusts can uphold patient confidentiality and avoid incurring legal penalties.

You can find out more about the solution here.

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Summary Care Records will Focus on Ownership of Information

Debbie Williams

Blog, Wednesday 16th June 2010

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Last week the Health IT Minister announced the continuation of the Summary Care Records. Smart Healthcare this week reported that Simon Burns told the British Medical Association (BMA) in a letter that SCR is under review with a ‘focus on ownership of the information’.

The Summary Care Records have come under intense criticism by many and the majority agree that the main problem of the records is in fact the way the programme was implemented rather than the online records themselves. Ultimately Mr Burns feels that the success of the Summary Care Records relies on the patients and the doctors and how they perceive the records, this can be acheived by making the process transparent for both parties.

The Summary Care Records are a central part of one of the most controversial elements of the NPfIT, the biggest healthcare IT programme in the world. To make the records a success all stakeholders must be informed of how the records will work, how patients can opt out of the records and the timeline of the roll out as these are the key issues many are concerned about. In order for the records to surpass expectations these key issues must be resolved, this should eventually result in the online records improving the quality and safety of treatment provided by hospital staff and out-of-hours doctors by giving them as much information to improve overall patient care.

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NHS E-Record System Goes Live at Morecambe Bay University Hospitals

Debbie Williams

Blog, Friday 4th June 2010

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E-Health Insider has reported that Lorenzo Release 1.9 went live at Morecambe Bay University Hospitals over the bank holiday weekend.

The trust is the first acute hospital to use the Lorenzo software with patient administration functionality. The software is being used by 3,500 staff across its five hospitals for all clinical activity and will change the way Morecambe Bay keeps patient records from being largely paper-based to a new electronic health record.

The software, which was designed by CSC’s sub-contractor iSoft, is a key part of the NHS’s £12bn National Programme for IT but has been plagued with delays.  It is still not certain exactly what the new coalition government’s plans are for NPfIT, but this is a significant step forward for the programme, so it will be interesting to see the results achieved by Morecambe Bay.

The push for electronic records, while often surrounded in controversy, does offer many considerable tome and cost savings to the NHS and so if implemented with the correct support and training, may offer great rewards to all those who use it.

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NHS Faces Job Cuts as £2bn Fund Set up to Cover Payouts

Debbie Williams

Blog, Friday 21st May 2010

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The Guardian has reported that the NHS has set aside a £2bn fund to cover the cost of payouts for redundancies as the NHS is facing a significant amount of job cuts, despite the government stating that NHS services will not be affected by budget cuts.

NHS trusts will be told to put aside two per cent of their funds for this year for one-off costs. This comes as last month, the Royal College of Nursing (RCN) warned that thousands of jobs would go in the health service as part of a drive to find between £15 and £20 billion of “efficiency savings” over three years.

The need to cut costs with such a huge economic deficit is of paramount importance but there are many ways to cuts costs that will not see the reduction of staffing and as a result not see the quality of patient care fall in the NHS. The scale of these cuts highlights the importance of efficiency savings wherever possible. Effective use of IT in healthcare, such as business intelligence, is a primary method to achieving this.

There has yet to be much mention of the plans for the National Programme for IT, but it is likely that there will be some announcement on this in the coming weeks, as the Liberal Democrats had wanted to scrap the programme altogether and with their position in the new coalition government it is not at all clear what the future is for NPfIT.

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Controversy Continues with SCR

Debbie Williams

Blog, Friday 14th May 2010

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The NHS have been accused of scaring patients into agreeing to have their personal information included on the controversial electronic records database, the Telegraph reports.

The Summary Care Record is intended to make it easier for doctors and nurses to get access to patients’ medical details, but has had somewhat of a shaky start, with many patients claiming their records have been created without their consent. Currently, there are more than 1.25 million patient details on to the database, which eventually could hold up to 50 million records.

As the new coalition government sets to work on reducing the nation’s deficit, issues such as SCR and the controversial National Programme for IT are no doubt going to receive their fair share of attention, and it is unclear as to whether they will survive or not. Healthcare budgets are already under immense pressure, so any move by the new Conservative and Liberal Democrat government to cut funding within the NHS is likely to come under fire.

NHS Trusts therefore need to be looking at ways they can improve processes they already have in place, making healthcare organisations more efficient and economical. Business intelligence is an effective means of helping trusts and health boards to ensure valuable NHS resources are used in the best manner. Ardentia’s Patient Level Costing solution even provides data on the use of ward space, time in theatre and the number of staff used for medical procedures. This information allows trusts to make targeted improvements where needed, and to also learn lessons from those departments running well, to reduce costs and streamline productivity.

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Is the NHS Doing a Good Job? Not According to its Patients

Debbie Williams

Blog, Tuesday 20th April 2010

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Almost three out of five British people do not believe the NHS is doing a good job, according to an international survey reported by the Telegraph. The Deloitte 2010 Survey of Health Care Consumers found that only 30% gave the NHS a grade of very good or excellent.

The survey questioned at least 1,000 people in six different countries on various subjects, including satisfaction with hospital care and overall GP service, with the NHS coming behind healthcare systems in Canada, France and Switzerland, but better than Germany and America.

Only 65% of Britons questioned said they were satisfied with their GP and claimed that having the ability to email their physician would help improve the service. This revelation emphasises how important the development of IT in healthcare is, not just for the communication between medical staff, but also for patients.

The internet, and email in particular, is such a big part of so many people’s lives these days and by offering patients the option of using this form of communication to correspond with their GP it provides them with far more flexibility.

While the National Programme for IT faces many critics and is not without its problems, the underlying point of the scheme is to incorporate the latest technology to offer patients and medical staff a better National Health Service, and as highlighted by this survey, this is something that patients are very keen to see happen.

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Department of Health Looks to Help Doctors Engage with Patients

Debbie Williams

Blog, Tuesday 13th April 2010

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EHealth Insider has reported on a new system launched by the Department of Health to encourage doctors to engage more with patients to find out more about what their views are on subjects such as treatment, experience and information available.

The new system, entitled the Invest in Engagement tool, analyses almost 300 research reviews and it is hoped that this will allow doctors to see what areas are working and where improvements need to be made.

This programme is an encouraging use of the online facilities available to the NHS, with it offering patients the opportunity to feedback to doctors their opinions on services. If the National Programme for IT is to succeed then such initiatives as this are required to help outline the importance of IT within healthcare.

Such a service highlights the importance of keeping patients at the centre of the NHS and not getting too distracted by efficiency savings and government targets, especially in the run up to the election.

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GP Survey Reveals Support for Cuts to NPfIT

Debbie Williams

Blog, Wednesday 17th March 2010

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A recent survey of GPs has revealed that more than half believe the National Programme for IT in the NHS is an appropriate target for cuts in the current economic climate. In the survey by Pulse magazine, over 900 GPS were questioned, with 52% indicating they would be in favour of budget cuts to the National Programme for IT.

The survey results, which are reported on E-Health Insider, show NPfIT to be the third most popular target for budget cuts behind only Darzi-centre contracts and managerial headcount and salaries.

With the election build up really starting to gain pace, NPfIT and efficiency savings in the NHS are guaranteed to be at the heart of many political discussions. The support for budget cuts to NPfIT demonstrated by these survey results is hardly surprising, as there has always been much controversy surrounding the programme. However, it is important that we do not overlook the successes that it has achieved to date, with the systems that have been implemented so far offering benefits to both clinicians and patients.

The debate over NPfIT has always been ongoing, but the next few months are likely to see the spotlight thrust onto its short-comings to provide political leverage in the run up to the election. This is despite the government having already made the announcement at the end of last year on the £500m – £600m budget cuts to the programme.

It would be easy for certain political parties to jump on the ‘anti-NPfIT bandwaggon’ in the name of healthcare efficiency savings, but in spite of its short comings, NPfIT has begun to prove demonstrable benefits that should not be easily dismissed.

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Legal Eagles Swoop to Take £40 Million in Fees From NPfIT

Debbie Williams

Blog, Friday 29th January 2010

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A written exchange between the minister for health and his Conservative counterpart unveils the multi-million pound legal fees so far accrued for the National Programme for IT.  NPfIT has accrued nearly £40m of legal fees in seven years, according to minister for health, Mike O’Brien.

The NPfIT has been under renewed pressure in recent months, following confirmation from both sides of the House of Commons that it would be reduced in scale to varying degrees or even scrapped.

The NHS’s flagship IT programme – the largest civilian project of its kind in the world – risks becoming somewhat of a political football in the run up to the election, and perhaps unfairly so, because NPfIT has achieved much to be proud of in recent years, with the systems in place delivering real and tangible benefits to both patients and clinicians.

However, some will point to these latest £40m legal bills as further evidence that NPfIT is not working, and that the concept of a truly national infrastructure does not represent best value for the taxpayer, arguing that smaller, localised systems would be cheaper and more effective.

At a time when healthcare budgets are under pressure, should funding not be focused on frontline healthcare provision?  Or is such a view short-sighted, and do we need to simply keep the faith that NPfIT ultimately deliver improved service, increased efficiency and best value?

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Answering NPfIT’s Harshest Critics

Debbie Williams

Blog, Tuesday 15th December 2009

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The Telegraph this week published an angry tirade descrying the National Programme for IT as an expensive, inefficient and chaotic waste of £12 billion of taxpayers’ money.

Would you agree?

The article suggests that the flagship NHS system is not fit for purpose, and that on the occasions that it does function as promised, the patient information is largely irrelevant to frontline staff delivering the care.

Of course, the priority for medical staff treating patients is and will continue to be that of stabilising the patient physiologically, but to suggest patient data is unimportant or even irrelevant to frontline care providers is dangerously wrong.

Access to patient data informs clinical staff of previous medical history, and of vital information such as whether the patient is allergic to specific drugs, such as emergency room anaesthetics and even common painkillers.  Not having such data to hand can serve to not only delay medical procedures, but could potentially impact on patient care.

No, the national programme for IT is not perfect, and there is certainly a long way to go until we have in place a fully electronic and truly national database and information exchange.  However, it’s all too easy to forget the significant progress that has already been made.

Four of the five IT systems are already in place and performing well, improving NHS performance and enabling key tasks to be carried out more swiftly and efficiently.  Giving clinicians access to quality data is central to them being able to deliver timely and appropriate care, optimising outcomes and the patient experience.

Improving the quality and quantity of patient data is a central plank in improving care delivery, and the national programme for IT is the means to delivering this across the vast NHS network.

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