OT NHS Summary Care Record

[dennis]

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You already trust them enough to give them the data if they ask for it (assuming you can actually tell them).

They already have the information.

They already have the information.

[John Rumm]

Once, on a need to know basis, where there is no confusion as to who you are.

Sat in a filing cabinet, or a standalone computer system at the surgery. A different proposition from it being to all intents and purposes "online" on an intranet.

See above. Different "they" for starters.

[Another John]

(Three good points.) With particular regard to ...

I was dismayed to see, looking over the shoulder of a nurse at my GP's practice the other day (a routine blood sample), that she had on her screen a list of *everything* that had gone on between me and my GP, including personal issues that I would not dream of discussing with anyone other than the GP, person to person.

All my fault (for being dismayed I mean). My mind was somehow rooted in the days when a GP might scribble the odd note on a set of cards, which were kept locked in a cabinet. That nurse (and all her predecessors and succeeding colleagues) would not have been given such ready access to the card records, as she has to the database which has replaced them.

As John said: there's an **immense** difference, in terms of accessibility, between old paper records, and a net-based database. I'm not really suggesting that anything can be done about it, but I myself (who worked in IT!) had not guessed that my personal records were so openly available to all staff in the practice (and -- as John has also said: elsewhere).

John

[dennis]

There is no such thing as a standalone system in nearly all surgeries. They are all a part of an intranet.

[dennis]

Are they? Different access rights can be set for each staff member. I doubt if the receptionists can access the records to the same extent that the clinical staff can. With the old paper notes the receptionists could just pick them up and do what they liked, they had to have access as they sorted them so they were there for your appointment.

At least with the computer records the audit trail will allow you to find out who and what they looked at.

[Roger Mills]

I had precisely the same experience - which reinforced my determination to opt out of having a Summary Care Record splashed all over etherspace!

[John Rumm]

They are networked certainly. However one surgeries systems do not necessarily talk to others, or to the local hospitals, or offer access to remote users etc. They are non connected systems - in both the logical and the physical sense.

[John Rumm]

Almost certainly... probably not at every surgery, but certainly at some.

They can, however to an extent this requires a certain level of understanding and administration which may well not be available. When security conflicts with convenience (which it almost always does), human nature will tend to circumvent the former for the sake of the latter. Hence access rights get toned down such that once you have entered your basic password all is laid bare etc.

I don't share your faith... They may not have it thrust in front of their faces in quite the same way, but don't doubt they have ways of having a peak if they fancy.

And hence very much more visible if you want to get copies out of the building, than just logging into the unprotected wifi from the car park.

If enabled... also many forget that the audit trail in itself becomes a valuable source of meta data.

[John Rumm]

Mind you, I had almost the inverse experience once - went to the local surgery for a blood test, but forgot to take the printout the nurse gave me the previous week with the required tests detailed on it. Even though the Phlebotomist had access to my records and the appointment details on her computer, she could not actually find any details of the tests required or samples to take!

(Just as well I am good at remembering arcane strings of acronyms!)

[dennis]

Test results are networked, hospital appointments are networked, even prescriptions are networked in some. You may think they are separate but they aren't.

I think you should try and get the old, less secure manual notes reinstated.

[dennis]

That requires quite a lot more than you think.

1: it needs unsecure wifi. 2: it needs the software on the laptop 3: it needs a valid login 4: it needs a passcard reader in the laptop 5: it needs a valid passcard

There is no if about it.

It was far easier to put the manual notes on a copier and take the copies home.