Despite a historic Government mandate promising NHS patients they will be able to access their health records online by 2015, just 4% of GP clinical commissioning groups say their IT systems are live, raising concern they remain unconvinced of the benefits of the proposals.
An eHealth Insider (EHI) survey carried out by Doctors.net.uk has found that almost no practices in the UK are ready to start delivering on the Department of Health’s pledge, with almost half having given the issue no thought to date.
Giving patients more control over their healthcare by enabling them to access their GP records online could bring significant benefits to the individual and NHS alike. However, it represents a huge cultural shift for doctors
A total of 1,000 GPs responded to the survey, with 43% saying they ‘haven’t started to address this year’ when asked how prepared they were to facilitate patient access to online health records. Another third said their systems still needed work, with 15% saying they were ‘a long way from being ready’, 9% saying they were ‘nearly ready’, and 5% claiming they were ready but not yet live. Just 4% of respondents said they were already providing patients with access to information held about them.
More alarmingly, a quarter of GPs – 24% - said they did not know how ready their practice was and just 27% said they were in favour of the Government’s 2015 deadline, with 48% against and as yet 25% undecided. In addition 29% question whether giving patients access to their records is actually useful, with a further 21% undecided. Less than half - 49% - agree it will be a useful development.
And fears that older GPs are not embracing the IT revolution seem unfounded, with the survey finding the GPs more likely to be against the move are those aged under 30, with over-60s more likely to back both access and the target date.
Commenting on the findings, EHI editor, Jon Hoeksma, said: “The promise that patients should have online access to their GP-held records by 2015 was a central commitment in the NHS IT strategy, However, this survey shows that many GPs have yet to start working on the systems they will need to put in place to make the pledge a reality.”
He added: “IT is not the problem. The majority of GP systems in the UK can support patient access, or will do so shortly. Instead, more GPs need to be convinced that the Government’s promise is worth delivering.”
This survey shows that many GPs have yet to start working on the systems they will need to put in place to make the pledge a reality
This concern is echoed by Dr Tim Ringrose, chief executive of Doctors.net.uk. He said: “Giving patients more control over their healthcare by enabling them to access their GP records online could bring significant benefits to the individual and NHS alike. However, it represents a huge cultural shift for doctors.
“Our survey suggests that many doctors have yet to be convinced of the merits of this system and this may explain why few practices are ready to embrace it. As the UK’s largest and most active network of doctors, we will be advising and supporting GPs as they work towards this key Government objective.”
And this is not just the case in England and Wales. In Scotland, 53% of GPs said they were yet to start addressing the issue, with only 4% having a system that was already live.
This cautious approach to the adoption of IT systems does not just apply to patient records access. The survey also found that there was also little enthusiasm for email consultations with patients; a move that is being mooted as a way of improving GP access and saving time and financial resources.
IT is not the problem. The majority of GP systems in the UK can support patient access, or will do so shortly. Instead, more GPs need to be convinced that the Government’s promise is worth delivering
According to the results of the survey, 79% of GPs said they had never tried to liaise with patients via email, with a further 58% saying they had never interacted with patients via social media networks. Of those who do offer so-called e-Consultations, 14% do this only once a week. A total of 4% of respondents said the had tried it, but no longer offer the service.
This is in contrast to long-term plans for the future delivery of healthcare services in the UK, which call for more electronic interaction with patients so that GPs and hospital medics can concentrate on more serious cases and deal with common ailments and queries without having to physically see and examine patients.
The Government first set out its vision to introduce the system within the next two years in its NHS IT strategy, The Power of Information . It then issued a mandate to the NHS Commissioning Board in planning guidance for the future of the NHS.
Commenting on the problem, one GP at a practice in England, who did not want to be named, said: “Am I one of those GPs who is not doing anything about access. Why? Am I anti access? Am I a bad doctor? Am I a luddite? Do I not care? No to all of these. It is due to practicalities and priorities.”
He said that as well as his clinical system not being able to provide access yet, with the pending switchover to GP commissioning doctors had a host of other things to sort out.
When we know more and some of the more pressing priorities have passed, we will move onto patient access. Until then it will have to wait
He added: “At this precise moment we are planning for the introduction of electronic prescription requests, contract changes post April 2013, new area teams post 2013, the replacement of QMAS, CQC registration demands, MIG and consent issues, Vision 360, the use of Eclipse, ETP2 and QOF changes, to name but a few. All of these are real and happening now. Should we, instead, spend our efforts guessing what we should be doing regarding patient access? When we know more and some of the more pressing priorities have passed, we will move onto patient access. Until then it will have to wait.”
But there are some GPs who are embracing change. Probably the most vocal is Dr Amir Hannan, who works at Houghton Thornley Medical Centre in Hyde.
He has said: “The NHS needs to change. The patient is also an expert who understands how their condition affects them, their family and others around them. By providing the same breadth of information that is available to me responsibly to my patients, ensuring at the same time patients have access to information that supports their understanding of the data, a huge shift in the way care is delivered occurs before our eyes. Patients who do this report needing to see the doctor less often and feeling better prepared to navigate the system.
Patients gaining full access to their health record is liberating for patients and doctors alike and our experience is that this is safe when properly introduced and managed
His practice started providing patients with online access to their records five years ago and was one the first of the 100 currently offering the service.
He said: “Patients gaining full access to their health record is liberating for patients and doctors alike and our experience is that this is safe when properly introduced and managed.
“The government announcement that GP records will be available to all patients by 2015 is encouraging. There are huge challenges to be faced, but participatory medicine will increasingly be the key to meeting the challenge.”
Mark Clark, vice president of international sales at healthcare IT solutions supplier, Imprivata, said the Government’s target was a tough ask for GPs in the current climate. He told BBH : “Meeting the requirements for GP practices to support patients who want to access their records online by 2015 is a huge task which requires changes in technology and workflow. So it’s naturally a significant challenge.
“It appears as though there are a few factors at play which are slowing the progress of technology adoption. Integrating a completely new way of working into an established system is bound to be met with some form of resistance, particularly in an industry like healthcare, which has unique data security and workflow challenges, unless it proves to be easier than the previous method.
“Moreover, the Government’s goal is no small task and it will take an unprecedented amount of work in terms of planning and deployment. This report does suggest that GP practices that have ‘taken the plunge’ and begun to offer online access to records are seeing the benefits. In this way, it’s promising to see that progress is being made, slowly but surely, to allow for a more streamlined and connected way for critical health information to be shared between healthcare practitioners and patients alike.”
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