BBC medical records story

[Adrian Midgley]

On Wednesday 06 March 2002 04:26, you wrote:
> On Tue, Mar 05, 2002 at 11:44:27PM +0000, Adrian Midgley wrote:
> > Smart cards are a way of taking control and getting lock in on the
> > software used for medical record editing.

> ... having the 100+ GP system and 30-odd Trust
> systems* actually getting reasonable correct historic data would be,
> ah, amazing.
> (* Those numbers may be wildly wrong, at best a wild guess)

Concur.  If it was anything it would be a summary (and not all practices =
have=20
their notes summarised) plus presumably each incident thereafter where th=
e=20
card was available.
If I could find any use for the card it would be as a key to access and t=
hen=20
decrypt the patient's records from their copy elsewhere, and if that acce=
ss=20
was only possible with the key it woudn't support what I do all day, becu=
ase=20
the key commonly wouldn't be there, and I do talk to patients on the phon=
e.

Of course there would be a back door, with doctors and hosptials able to=20
assert a need to bypass the key, which makes one ask why have it at all.

Numbers: there are 5 main GP system suppliers now plus assorted small one=
s. =20
None of them can transfer a record from one instance of their program to=20
another instance of the same program, running on the same server, never m=
ind=20
across the network or on a disc.  There are all sorts of FUD excuses, but=
 it=20
is in order to prevent easy migration of their customers.

> What is the actual intension, or problem this is attempting to solve?
I think th eoinly half way sensible answer given to that is that it would=
=20
make records available wherever the patient is.

>  a) a portable data format for health records
Yes please
>  b) a decentrized network of patient databases, securely access via NHS=
net,
>     administered and audited at the regional level with only traditiona=
l
>     "need-to-know" access to all records
I'd rather see it held at GP level.  10 000 practices.

>  I think the current thinking from DoH seems to be
> that data is "state-owned" rather than "taxpayer-owned".

Explicitly so.

--=20
=46rom one of the Linux desktops of Dr Adrian Midgley=20
http://www.defoam.net/            =20