Central database for all medical notes

[ricgem2002]

i can understand a central database for the hospital in a emergency to get access to your files because of urgency of treatment . what worries me is who else will be able to access these files ? is this another step towards more of big brother (government) finding out more about us ?

[andyofborg]

this part of the system is likely to be scrapped

[ricgem2002]

according to the doctors receptionist everybody is automatically put into the new system and if you dont agree you need to opt out

[Rupert_Baehr]

There are good arguments for and against.

 

My medical records are on a central database and if I attend any medical facility which has access to that database, the providers can find all the relevant information easily and accurately. Ordinarily (before I came here) I receive treatment from medical providers who all have access to that system.

 

Unfortunately sometimes I see doctors who are not in that system (this is a topical problem for me just now) and those doctors are not (necessarily) aware of the full story or what treatment I'm receiving elsewhere. I keep a copy of of my medical record, so that if I see a new doctor I can show her/him the necessary parts and hopefully give him/her a 'heads up' to reduce the chance if inappropriate treatment. - It's a bit of a 'hit and miss' method.

 

At the moment, I see a number of doctors each of whom can (and do) prescribe medications. - I'm not a pharmacist, the doctors are not aware what the others have prescribed and the chances of medical conflicts are perhaps a bit too high. A centralised database (should) obviate(s) that problem.

 

If you're going to have records on a centralised database, then the patient must be identified very clearly. Name alone is inadequate. - A couple of years ago my wife and I had both had a dental check-up and the dentist I was seeing had decided to repair a filling in my mouth. He seemed to be having problems trying to find the defective filling.

 

That was because he had found too many teeth and was confused. - He had my wife's dental records and couldn't reconcile them with my teeth.

 

Amusing perhaps, but it might've not been so funny had it been a doctor doing some other procedure.

 

I would prefer that my records were on a central database and that all healthcare workers who treat me should have access to it - and I'd prefer that they checked it before they provided the treatment, so that I didn't get inappropriate treatment.

 

A few years ago, a part of that database was compromised and I - along with many thousands of other people - was advised that a part of my medical records may have been accessible to unauthorised people. That's unfortunate and I'd rather it hadn't happened, but given the choice between a slight risk of unauthorised access and a (perhaps significant) risk of inappropriate treatment because a provider didn't have access when (s)he needed it, I know which option I would prefer.

[ricgem2002]

A few years ago, a part of that database was compromised and I - along with many thousands of other people - was advised that a part of my medical records may have been accessible to unauthorised people. That's unfortunate and I'd rather it hadn't happened, but given the choice between a slight risk of unauthorised access and a (perhaps significant) risk of inappropriate treatment because a provider didn't have access when (s)he needed it, I know which option I would prefer.

i agree about your treatment part but its the unauthorised part what i dont get (and who will be authorised/not to access these details) will other people such as dentists.carehomes,social workers and anyone not having this available to them would now be able to get access

[Rupert_Baehr]

Swings and roundabouts, I suppose.

 

40 - odd years ago my grandfather (who was only 65 and in otherwise fairly good health) went into hospital for an investigation which involved minor surgery. He died of post-operative thrombosis. It was a probably avoidable death, but the doctors who treated him were not aware that he had a history of thrombosis. Had his records been on a centralised database (which certainly didn't exist then), then presumably he would have been given something to prevent the problem from occurring.

 

5 years ago my MIL (who was in poor health) came to live with us. When I saw the medications she brought with her, I made an appointment for her to see a doctor just to get the meds checked. - She had been seeing 2 or 3 doctors previously, there was little (or no) communication between them and she had been taking medications which were known to interact adversely.

 

As for dentists having access to medical records, why not? - They are providing medical care. Until recently, (where I received dental care) if you had a heart murmur and you were going to receive dental treatment it was recommended that you take a large prophylatic dose of antibiotics. The practice has changed and those high doses of antibiotics are no longer deemed necessary, but if they were necessary, if the dentist did not know about the heart murmur and either the patient didn't know or simply forgot to tell the dentist, who would be responsible if the patient contracted a major cardiac infection? (Prophylactic antibiotic treatment is no longer recommended, but I saw a British news article last week announcing the 'recent' (in the UK) discovery linking dental health with heart disease.)

 

At the moment, I'm (just about) capable of monitoring the combinations of medications and treatments a combination of doctors give me. (As I said, it's a topical problem. - I saw 4 doctors last week, most of them know little about what the others are doing.)

 

There have been a couple of medication changes - which may well change again on Monday - and I have to adjust some medications for a few days before I go into hospital.) Not a huge problem, but when I get older then - should I ever end up in a care home - it's a pretty good bet that I will need some assistance. I would prefer that the care home actually knew about my medical problems than that they simply 'had a go'.

 

It may be helpful for social workers to know about the medical conditions of their clients. - I assume a social worker helping somebody suffering from schizophrenia (for example), somebody treated through the 'care in the community on the streets' scheme might be able to provide better support if (s)he had adequate information.

 

As for other people, most don't need to know. There is an argument for insurers to know what risks they are insuring against (hence the sometimes long list of questions you have to answer when you apply for cover.) There has, however, also been debate about whether genetic information should be released. If an insurer knew that an individual had a genetic pre-disposition towards a particular disease, then that person might find him(her)self uninsurable. - Perhaps the answer there is for the State to provide the insurance cover?

[cgksheff]

My GP is incapable of looking at my existing history as it comes up on the screen in front of him so as to take any interest in what has gone on.

 

My consultant has been unable to look at the notes in the folder in his hand to know that he had already operated on me.

 

Why would centralisation make this any better?

[Daven]

There's a good argument for the suggestion that every person is responsible for carrying a record of their health history and any medication being taken - just a brief resume of their medical history that can be seen by any health care professional either in an emergency or otherwise if necessary. This would also put some of the responsibility on the patient and, maybe, make them a little bit more aware of any conditions they may be suffering from.

[ricgem2002]

As for other people, most don't need to know. There is an argument for insurers to know what risks they are insuring against (hence the sometimes long list of questions you have to answer when you apply for cover.) There has, however, also been debate about whether genetic information should be released. If an insurer knew that an individual had a genetic pre-disposition towards a particular disease, then that person might find him(her)self uninsurable. - Perhaps the answer there is for the State to provide the insurance cover?

so we now have insurance companies being able to (in your words)access these records, this is what i am talking about we have now gone from these records being used by only the medical proffesionals to insurances companies .what next police ,councilworkers,teachers etc ?

[onewheeldave]

The whole things a total disgrace.

 

Firstly, such a thing should be a opt-in process i.e. those who want it should give their permission.

 

The reality is that it's opt-out i.e. everyone is automatically enrolled unless they object.

 

I know several people who've not even received letters informing them of the fact they're going to have their medical records uploaded to this database despite the fact that they know nothing about it and are thus unable to withhold permission

 

Secondly, the letter sent out contains no opt-out form- you have to go on the internet to print one off.

 

Why has this been made opt-out and why have there been deliberate obstacles placed to make opting out more difficult? I can only conclude that it's cos those trying to set up this database know full well that a significant portion of the population, when presented with a genuine choice, would be wish to go on that database.

 

It's dishonest.