Patient records database should be refined, says report

Research into the Summary Care Record programme shows that benefits are overshadowed by issues of trust and complicated technical systems.

A central database containing patients' details may offer valuable benefits but must be refined before being rolled out, according to a report by a University College London (UCL) research team.

The Summary Care Record programme is an initiative by the Department of Health in England to place key medial details of NHS patients on a central database, accessible by NHS staff through a secure virtual network.

Despite finding that the programme would improve efficiency of care, the year-long independent evaluation also revealed that the programme's "complicated" technical system needed to be reconsidered. NHS staff who attempted to use the SCR programme when caring for patients felt that the current version was technically immature and described it as "clunky" and "complicated".

The report also found that although technical security of SCR is to be high via a system of password protection and strict access controls, there is still a concern among patients and staff, triggered by government data breaches, that human error could put the operational security of the system at risk.

In the report, the London GP who led the research, Professor Trisha Greenhalgh said that the SCR programme's success depended on how it was used and the extent to which it is trusted by NHS staff and the public.

"As an innovation, it has both potential benefits and potential disbenefits [sic]. Its 'success' will depend to a large extent on how it is used and the extent to which is it trusted."

Many NHS staff and patients valued the benefits of instant access to medical records over the small risk of data loss or breach, with 80 per cent of patients asked being either positive or indifferent about the programme. However, others were strongly opposed "on principle" and a significant minority of GPs had chosen not to participate in the programme.

Professor Greenhalgh added: "We now need to refocus the debate on how the balance between 'benefits' and 'disbenefits' [sic] might play out in reality for different individuals in different circumstances and how these circumstances may change over time."

A comparable technology called the Emergency Care Summary was introduce in Scotland two years ago and is working adequately with over a million records already accessed in emergency and out-of-hours care.

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