GPs who move their electronic patient record data to new systems may have to keep the old ones running concurrently for legal reasons, it was suggested at the primary care forum at Healthcare Computing 2005.
Dr Glyn Hayes, chair of the British Computer Society Health Informatics Forum, who spoke at the ‘Primary Care in the world of the National Programme for IT’ panel session at Healthcare Computing 2005, pointed out that for electronic records to be legally valid one must be able to prove their origin of entry.
"If those records are required in a court as evidence there’s an interesting conundrum," he said. "If you move data from one system to another you have broken the audit trail. You might have to keep the old system as well as the new one."
Dr Hayes added: that transfer between "old systems and new ones has always been done badly. I don’t know of any conversion of data that has gone well."
Ewan Davis, chair of the Primary Health Care Specialist Group of the British Computer Society, added that in any large-scale upgrade of systems, there will always be a sharp drop in the effectiveness of an organisation before it reaches pre-upgrade levels and then improves.
In a panel discussion dominated by the issues generated by the issues surrounding transferring data currently held by GPs to the spine, another hot topic was the security and ownership of electronic patient records.
Davis was complimentary about NPfIT’s work in the field so far. "The model that I have seen in terms of managing security is quite impressive. But I can understand the reluctance to share work in progress as there’s a history of paralysis by analysis."
Dr Fleur Fisher, panellist and independent consultant on ethics and healthcare, commented: "The public has more naus about the NHS than we give them credit for."
However, she said, NPfIT was going to cause an enormous shift in the relationship between the patient and the GP, as information that patients would be happy telling their GP may end up going on the spine and that personal relationships with their GP may end up becoming public.
Dr Fisher also added that the public needed to know more about the sea change about to take place, but added that the new name for NPfIT, ‘Connecting for Health’, was a positive step towards getting people involved.
One delegate commented that nobody wanted every single, potentially embarrassing part of their electronic patient record held on the spine unless they suddenly were involved in a motorway crash: "Until then, I don’t want anyone to know that I used to be Maureen."
One suggested solution to the problem was the development of a ‘virtual GP record’ held in parallel to the record on the spine that would not be shared with anybody. Another delegate suggested the possibility of keeping simple, encrypted freetext records that would be human-readable but not coded.
Speaking to E-Health Insider after the event, Dr Glyn Hayes said that it was important that the forum had had a constructive discussion about data quality and security issues.
On the whole, the enthusiasm and interest for change at the BCS HIF was high. Ewan Davis commented: "It will be churlish not to welcome the £30 billion [put aside for NHS IT]. I welcome the new resources… Some of the old guard want to return to the status quo. That’s not the position we take."