GPs worried about having to change to new untested software systems
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《英国医生杂志》
London
By 2010, every patient in England should have an individual electronic NHS care record.
In essence, this refers to a computer file that includes general practice and hospital records, detailing key treatments and care.
The 10 year contract to set up and run the NHS Care Records Service (NHS CRS) was awarded to BT in December 2003 and is worth ￡620m ($1.1bn; 932m).
The service will connect more than 30 000 GPs and 270 acute, community, and mental health NHS trusts in a single system.
Although much of the work is being developed nationally there are important local variations. BT will be the national application service provider, responsible for all services that are common to all users nationally, but the five separate NHS regions in the NHS National Programme for Information Technology each has a local service provider. Accenture, for example, will be local service provider in two of the regions—the East and the North East.
Dr Philip Posner from the James Wigg Practice in north London, a large "paperless" general practice, is positive about the NHS Care Records Service but has grave concerns about its implementation.
A majority of GPs in England use the EMIS system but this system has not been chosen as the preferred software system by any of the local service providers
Credit: ANTONIA REEVE/SPL
He believes the only way ahead is "national standards, coming from the centre." Yet EMIS, the system used by most GPs and which stores around 36 million patient records, has not been chosen as the preferred software system by any of the local service providers.
"Richard Granger has said that EMIS will be able to communicate with the NHS CRS and therefore be part of it," explains Dr Posner, "but the fear is that if your system is not the preferred provider the ultimate aim is to move to a new system, which means billions of pounds of procurement money, and historically if you change one system for another it spells missing data and huge training implications. We are being asked to change one tried and tested system for one that, in some cases, hasn't even been written yet."
He does, however, allay consumers' fears about confidentiality: "People always fear information can be hacked into. I have always felt that computer records are more secure than paper. You need a password for a start, and, in our practice, there are also different levels of access. Previously all staff had to do was pull paperwork from the shelf. We had a major flood, and our main server was under six inches of water, but we didn't lose any data. And we had back-up disk in a safe. Imagine if that had been 15 000 paper records."
A survey of 2000 patients by the Consumers' Association (Health Which?, 7 October 2003) found an overall positive reaction by patients to NHS CRS. They especially welcomed the opportunity to record their wishes on their medical record and have access to test results, their medical history, and prescription information.(Rebecca Coombes)
By 2010, every patient in England should have an individual electronic NHS care record.
In essence, this refers to a computer file that includes general practice and hospital records, detailing key treatments and care.
The 10 year contract to set up and run the NHS Care Records Service (NHS CRS) was awarded to BT in December 2003 and is worth ￡620m ($1.1bn; 932m).
The service will connect more than 30 000 GPs and 270 acute, community, and mental health NHS trusts in a single system.
Although much of the work is being developed nationally there are important local variations. BT will be the national application service provider, responsible for all services that are common to all users nationally, but the five separate NHS regions in the NHS National Programme for Information Technology each has a local service provider. Accenture, for example, will be local service provider in two of the regions—the East and the North East.
Dr Philip Posner from the James Wigg Practice in north London, a large "paperless" general practice, is positive about the NHS Care Records Service but has grave concerns about its implementation.
A majority of GPs in England use the EMIS system but this system has not been chosen as the preferred software system by any of the local service providers
Credit: ANTONIA REEVE/SPL
He believes the only way ahead is "national standards, coming from the centre." Yet EMIS, the system used by most GPs and which stores around 36 million patient records, has not been chosen as the preferred software system by any of the local service providers.
"Richard Granger has said that EMIS will be able to communicate with the NHS CRS and therefore be part of it," explains Dr Posner, "but the fear is that if your system is not the preferred provider the ultimate aim is to move to a new system, which means billions of pounds of procurement money, and historically if you change one system for another it spells missing data and huge training implications. We are being asked to change one tried and tested system for one that, in some cases, hasn't even been written yet."
He does, however, allay consumers' fears about confidentiality: "People always fear information can be hacked into. I have always felt that computer records are more secure than paper. You need a password for a start, and, in our practice, there are also different levels of access. Previously all staff had to do was pull paperwork from the shelf. We had a major flood, and our main server was under six inches of water, but we didn't lose any data. And we had back-up disk in a safe. Imagine if that had been 15 000 paper records."
A survey of 2000 patients by the Consumers' Association (Health Which?, 7 October 2003) found an overall positive reaction by patients to NHS CRS. They especially welcomed the opportunity to record their wishes on their medical record and have access to test results, their medical history, and prescription information.(Rebecca Coombes)