Data Sharing Review

[Michael Simpson]

Hi Mary

answers in-line

On 7/15/08, Mary Hawking <maryhawking@tigers.demon.co.uk> wrote:
> Michael Simpson said
>
> > As a medic with an interest in developing an electronic patient register i
> would be unhappy with the concept of any data sharing without the specific
> consent of the patient being given *every* time that their data is to be
> accessed by anyone.
> >
>
> There is another problem about data sharing - the quality of the data to be
> shared.

oh indeed, garbage in - garbage out

> Mark Walport does not appear to have considered this as far as medical data
> goes - and medical data is, by it's very nature, imprecise, fuzzy and open
> to different interpretations in different parts of the health care system.
>
> Drug services are a case in point (cheer up, this problem only applies in
> England - so far)
>

We are an integrated service with 3 primary electronic systems, none
of which have any good quality data in them so whatever the condition
of the English services ours are significantly worse
-we have more people on substitute prescribing per capita than any
other country in EU yet we are unable to answer questions along the
lines of "how many people are in service?"
much danger, much risk, no information sharing!

> Data sharing of appropriate data in appropriate ways to support individual
> patient care is not and never has been a problem.
> Extending this to include *all* medical information to *all* health care
> providers (and pharmaceutical companies) is something different - and single
> shared records - the Detailed Care Record model in NME - Lorenzo level 4 and
> TPP - is a different problem again.
>
> Changing goal-posts - have you seen the Darzi review on Vision for Primary
> and Secondary Care para 7.6? Access to the National Care Record service -
> which includes both summary and detailed care records - to be extended to
> social services and voluntary organisations.
>

As said above i work in a health/social work/social care "partnership"
with a paper single shared assessment which is a bit of a disaster.

i just stick to the written medical notes.
> </rant>
> see my presentation at the PHCSG summer conference - www.phcsg.org.uk the
> Conferences - summer conference - program and day 1 stream 2 15.20
>

Very interesting and thank you for that.
The concept of RBAC is critical - assuming that you mean role based
access control. I use the same concepts with SELinux to decide who can
do what on my servers at a user level. We have mirrored this concept
in the electronic single shared assessment that my company (which we
run in our spare time and consists of 2 hugely geeky medics with 26
years NHS experience) is developing which is designed for use by
integrated teams.

> (Michael, I'll send it to you off line)
>
> Mary Hawking

best wishes

mike