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Patient-records project ploughs on - but its £700,000 evaluation isn't finished yet

DoH-funded study into electronic records to be published next month - after rollout has begun
Written by Nick Heath, Contributor

DoH-funded study into electronic records to be published next month - after rollout has begun

The Department of Health has spent more than £700,000 on a project to study the impact of introducing centralised medical records - but is pushing ahead with the project before the study has even been completed.

Health authorities in most areas of England are currently preparing to create Summary Care Records (SCR) - electronic records of a person's allergies and drug prescriptions stored on a central database.

Strategic Health Authorities across England have been given until March next year to begin creating SCRs for patients, with the first SCRs in the national rollout going live in London last November.

The national roll out of the scheme is now well underway in spite of the fact a study by University College London (UCL), funded by the Department of Health at a cost of £723,411 and designed to "inform the national roll out of SCR", will not be published until next month.

The evaluation, the second that has been undertaken by UCL, is examining how the SCRs have been rolled out in pilot areas in England and looking at issues such as the SCRs' impact on patient privacy and care.

Doctor's union the British Medical Association (BMA) claims it was given an assurance by the Department of Health that the national rollout would not get underway until UCL had published the findings of its second evaluation of the SCR scheme.

Dr Grant Ingrams, co-chairman of the joint GP IT committee with the BMA, told silicon.com: "We were never 100 per cent sure about the consent mode [for the SCRs, currently an opt-out model] and we had agreement to continue piloting it until the next [UCL] evaluation is out.

"The next evaluation is due in April but they are rolling it out widely before we know whether it is appropriate or not.

"Is it because there is money in this year's pot and they know in future money will be tight? Is it because there's an election coming up and they want something done?

"I don't know whether it's a cock-up or conspiracy."

A DoH spokeswoman denied that the BMA had been given a pledge that the national roll out of SCRs would not start until the second UCL evaluation had published its findings.

She said that UCL's second evaluation will still be useful in spite of the fact that the national rollout will be well underway before it published its findings.

"The terms of reference for the evaluation of Summary Care Records by University College London centre on learning lessons from the early adopters and the national rollout in order to continually improve the care they are delivering," she added.

According to the spokeswoman, changes have already been made to the SCR scheme following an earlier UCL evaluation in 2008, which means a patient's consent is now needed before NHS staff can access the patient's SCR.

The NHS is promoting SCRs as having the potential to save patients lives by allowing doctors unfamiliar with a patient, for example an out-of-hours or hospital A&E doctor, to be able to quickly and easily look up a patient's existing medication and allergies on their computer.

The BMA has expressed concerns over the consent model for the SCR - which is automatically created for a patient unless they choose to opt out of the scheme.

Publicity campaigns explaining what SCRs are - featuring leaflet drops, advice centres and local media coverage - will take place in every health authority area in England for at least 12 weeks before SCRs are created for patients.

If patients fail to opt out of having an SCR during that publicity period then one will automatically be created for them, using information held on their GP's computer system.

However an independent survey of patients in areas where the SCRs have been piloted found that seven out of 10 patients were unaware that SCRs were being created and UCL's first evaluation also found that the impact of publicity campaigns in pilot areas had been "disappointing".

"If seven out of 10 people in an area do not understand what is going on then the implied consent model is not appropriate," the BMA's Ingrams said.

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