1. Understanding the trade-off between security and accessibility Dr Amir Hannan Full-time GP Information Management & Technology Lead Tameside & Glossop PCT Member of the Records Access Collaborative Member of the HealthSpace Reference Panel (www.healthspace.nhs.uk) Member of the Clinical Leaders Network (www.cln.nhs.uk) amir.hannan@nhs.net Knowledge Driven Health-care Solutions 6 th November 2007

2. Security “Patients have a right to expect that information about them will be held in confidence by their doctors. Confidentiality is central to trust between doctors and patients. Without assurances about confidentiality, patients may be reluctant to give doctors the information they need in order to provide good care.”

3. Accessibility “Doctor, getting information from your practice is like getting information from Fort Knox” (relative of a patient)

4. A Consequence

5. The Solution The Partnership of Trust HealthSpace access to the Summary Care Record Internet Access to the full GP-held Electronic Health Record REAL-TIME DIGITAL MEDICINE

6. Case 1 Margaret Rickson, 79, accessed her records Learned about warfarin and INR from her record Joined the Patient Participation Group in order to… …Set up a WARFARIN clinic in the practice = KNOWLEDGE DRIVEN HEALTH-CARE SOLUTION

7. Case 2 Patient in residential home gave consent for her niece to access her records from Australia Within 30 mins of accessing her aunt’s records, she found a mistake Subsequently her aunt became unwell and died She was able to monitor all the medical management from Australia Her comments about the care received are very enlightening and show how carers can help even if they are from the opposite side of the planet She subsequently came to the practice to visit the doctor and the practice

8. Case 3 Blog posted on www.patientra.co.uk for the whole world to see and learn fromwww.patientra.co.uk

9. Real-Time Digital Medicine Benefits of providing access to secure Electronic Health Records for patients and clinicians Efficiency Clarity Safety Process is time neutral Effectiveness