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Online Electronic Health Record Viewing System
‘Empowering and Educating Patients’
 Download the full Pack to read & sign up
Medical_Record_ACCESS_Packv5.pdf
The Pilot for Online Medical Records Access started on 11 June 2007. 62 patients are currently signed up. Now we are granting access to all patients, pending completion of a questionnaire and acceptance of terms & conditions ! If you are a registered patient Email HERE to express an interest, giving your full name and date of birth, EMIS number if you have it (this is the number on the upper left corner of your repeat prescription slip marked Patient ID: ).
You may also print this form and bring to the surgery to express an interest in joining the Medical Records Access Pilot.
Initial problems & queries:
- You may notice EMIS ACCESS gets slow sometimes or refuses to login. This is an EMIS issue or a general web traffic issue and not related to our system. However, when the system runs a Backup from 11.30pm for 2 hours EMIS ACCESS does tend to go down.
- Some record entries are showing as dated in 1899! None are showing on the actual records that I can see. We have heard of this error next to the issue date of medications when EMIS is upgraded to a newer version. We expect this has something to do with the way the MR ACCESS software (PAERS) interacts with the EMIS database. I have contacted EMIS to alert them to a "gremlin in the system".
- Blood results when ordered in Hospital outpatients are not automatically sent via lablinks to our EMIS system. We can always go onto Hospital CRRS to look up all lab results and it even charts them in graphs etc. So often, particularly if normal results, it is not essential all results are on your records. However, we usually digitally copy them into records when looking them up on CRRS. Dr Barrett
You may also print this form and bring to the surgery to express an interest in joining the Medical Records Access Pilot.
During the Pilot, we are only signing up access for patients aged 16 years or older. In future, we will allow access to children’s records for parents or legal guardians, but only those with “parental responsibility” – a legal term.
Many patients now access their own medical records via the internet. In the USA this is very common, but about 20 practices in the UK also provide this service.
This includes an on online service to order repeat prescriptions and book appointments. (This service is available whether you choose to access your medical records or not)
This practice offers a system that allows you to view your medical record using a personal computer (PC) and the internet over a secure connection. This page explains what the system is and how you can use it. Before you can begin using the Online Electronic Health Record (EHR) viewing system we require you to register and consent to use the system in the GP practice.
As a Practice we believe that patients should have full access to data about them and that this will enhance safety and care. Dr Barrett has liaised with Dr Hannan, a General Practitioner in Hyde, Tameside & Glossop PCT who is a member of the National Records Access Collaborative, in order to bring this facility to our Practice. Dr Hannan has enabled patients to access their full GP held record over the internet for the past 9 months and have successfully recruited over 150 patients for this purpose.
Initially, he held a series of meetings once a week where patients wanting to access their medical records were invited to a lecture on what Records Access is, what the benefits are, what some of the issues are and how they are locally trying to overcome them. A supplier of clinical software, EMIS, is now piloting web-based record access before it is rolled out nationally.
‘Access by patients of their own records is an important corollary of access by clinicians. Only when patients know the contents of their record can they ensure its accuracy and give informed consent for disclosure’
- Good practice guidelines for general practice electronic patient records, GPC and DOH September 2003
What is the Online EHR Viewing System?
The system is a website that allows you to view your medical record over the internet from a PC. It allows you to easily and quickly view the electronic medical information held about you by your GP Practice.
The information is presented to you in a format that is easy to navigate and offers you links to resources such as patient information leaflets about diseases, tests, investigations, support groups and medications etc. There are also links to websites such as NHS Direct Online and Patient.co.uk where you can find additional information to help you understand and educate yourself about what you read in your health record.
Registering and consenting to use the EHR Viewing system
To be able to use the system you must have a PC with a web browser such Internet Explorer (version 6 or later) and have a connection to the internet.
You must also register with the practice and sign a consent form before you start using the system. Before you sign the consent form you should be happy that you understand what the system does, what your responsibilities are and how your data is stored. When you have had enough time to understand this you should consent by signature and hand the consent form to your GP receptionist.
Once you have consented you will be issued with a series of numbers that you must remember to allow you to access the system from any PC.
Any data held by the practice concerning you is subject to the regulations laid down in the Data Protection Act (1998). The consent is between you and your GP Practice.
How do I use the Online EHR Viewing System?
Click this SECURE LOGIN link and follow the instructions to sign up for and begin using EMIS ACCESS. If you have not registered before for EMIS ACCESS or have received a set of new login credentials then click on the “Create your account” link.
Once you have signed into EMIS ACCESS you must select the ‘View Medical Record’ section which will further prompt you to enter the password specifically assigned to allow you to view your online EHR.
When you have been correctly identified the system will allow you to view the parts of your medical record as described below. Use the menu and links to view each area of your medical record. There is an online help section to help you use the system.
TEST PATIENT
Contact dr.barrett@skybluemedicalgroup.co.uk to be advised of the test patient login.
What can I see on the Online EHR viewing system?
The system allows you to view the following areas of your medical record:
A summary that gives you the most important and recent entries in your health record.
Consultations including: date, practitioner seen, reason for visit, history, examination, outcome, investigations, etc.
Medical Record showing diagnoses, investigations, and procedures
Allergies.
Patient Information Leaflets linked from the diagnoses in the medical record section.
Results showing all investigations such as blood results, liver tests, blood pressure etc.
Vaccinations.
Medications.
Letters to and from the GP.
The system also allows you to send messages to your practice using a system in Emis Access.
Why have an Online EHR viewing system?
There are many reasons to provide you with access to your medical information. A few of them are listed below:
‘We want to develop a culture of openness, honesty and trust; to ensure that patients have the information they need to make informed choices; and to enable patients to become equal partners with health care professionals in making decisions about treatment and care.’ This is the response to the Department of Health from the enquiry into the Bristol Royal Infirmary Enquiry.
This practice believes that it is important for improved patient care and education that you are involved in your healthcare as much as possible.
Advantages to you, the patient:
No queuing to get results
You can check the accuracy of your medical record
It empowers you to become more involved in your medical care
‘Patients have the right to see their medical records, though in practice much communication between professionals is not available to the patient concerned. Patients often do not know why they are being referred, or what is being said about them.’
- The NHS Plan, Information to empower patients
Where is my confidential medical information held whilst I am viewing my online EHR and who has access to it?
The information you view on the online system comes from the clinical system in your GP practice. Portions of this information are encrypted (this means it is very difficult for someone else to intercept and read the information) and securely sent from the GP system to your PC web browser.
None of the medical information that is shown on the online system is held permanently on any computer except the computer which holds the original data in the GP practice.
When you log off from the online system or if a problem occurs with your computer, for instance a power failure, all your confidential medical information is cleared from the system.
Using the online system does not allow any extra people to view your medical information other than the people who would normally have access to it in the GP practice.
How will other people be prohibited from seeing my record?
To view your online EHR you have to identify yourself with passwords and PINs that only you know. Unless you reveal this information to someone else you will be the only person able to access your medical record via the online system
What if I find an error in my medical record or if I see someone else’s medical information?
If you find any errors or missing information in your medical record you can use the messaging system (if your practice has enabled it) to send the practice a message or alternatively you can tell the receptionist or discuss it with your GP. If you see someone else’s medical information you should immediately exit from the system and inform the practice staff.
What if I don’t want to register to use the PAERS System?
If you do not want to register to use the PAERS System you can still use all the practices’ services exactly as before. Your decision not to register will not affect your treatment or your relationship with your GP practice in any way.
One big problem was for patients to attend the meetings and for Dr Hannan to present to an ever growing number of patients who wished to access their records. In an attempt to try to stream-line the process and enable patients to access the information at a time of their choosing and in the comfort of their own home, Dr Hannan produced a DVD. Patients were invited to take the DVD home to watch the different chapters on their TV sets. Following this, they were asked to complete a short questionnaire which ensured that they had considered the issues and felt comfortable with going ahead and signing up for the service.
However demand seemed to constantly outstrip supply of the DVDs and there was increased interest for the videos away from the practice around the country and around the world. Hence to continue to provide a seamless service for people around the world to gain consent for records access or to understand the issues as he describes them in the personal consent process, the videos have now been uploaded to You Tube for you to watch wherever you have internet access.
Below are lists all the videos that can now be viewed (including separately their URL). Each video lasts up to 6 minutes and can be viewed as many times as you like.
After you have watched the videos and read the consent leaflet, you may be in a position to complete the enclosed questionnaire and return them back to the Practice. Your answers will then help the practice to determine what the next steps ought to be. Dr Hannan’s experience is that most people are eligible for accessing their medical records so long as they understand the issues and are willing to accept the potential risks as well as the benefits.
However, our Practice is mindful of The Data Protection (Subject Access Modification)(Health) Order 2000 (SI 20000/413) which exempts health records from the general right of access where such access would be ‘likely to cause serious harm to the physical or mental health or condition of the data subject or any other person’. (quoted from Bridget Dolan, “Medical records: Disclosing confidential clinical information” Psychiatr. Bull., Feb 2004; 28: 53 - 56.)
What is third party information? This is information given to a GP from someone else, perhaps concerned about your health, such as Social Worker or a friend or relative. On some occasions the information giver wishes not to be revealed as the source of information. Mostly this is so as not to jeopardise their relationship with the patient. Sometimes they worry about harassment from the patient if the patient believes them to be responsible for them being admitted, sectioned etc. Rarely they worry about being risk of attack from the patient.
The Court of Appeal has confirmed that common law does not give an unconditional right of access to one’s own medical records. In the case of R v. Mid Glamorgan FHSA ex parte Martin [1995], a patient with a long mental health history was refused access to his clinical records on the grounds that disclosure would be detrimental to him.
The Data Protection Act 1998 currently provides individuals with a statutory right of access to their ‘personal data’. This includes information about their physical and mental health. However, the common law position in ex parte Martin (above) is now echoed in the statutory provisions. The Data Protection (Subject Access Modification)(Health) Order 2000 (SI 20000/413) exempts health records from the general right of access where such access would be ‘likely to cause serious harm to the physical or mental health or condition of the data subject or any other person’. Where a patient requests access to their own records under the DPA and the person controlling the records is not a health professional (e.g. a Trust Administrator), there is an obligation to consult the person most recently responsible for the clinical care of a patient and confirm that there is no risk of harm before releasing the records to the patient.
In other words, if your records contain substantial third party information or we feel disclosing all information may cause harm to you as the patient or to the information giver (eg such as causing difficulties in GPs relationship with the patient or a relative) then we have a statutory duty to withhold it from the you. Therefore, on rare occasions permitting full online records access may not be appropriate. This can only be considered on a case by case basis. This would be likely for very few patients, and we would be prepared to grant supervised access by inviting you to a meeting with your GP who will go through you paper and electronic records in a more controlled and supportive environment.
If you would like to know more then please see www.icmcc.org and click on “Records Access”. Also click on “Blog” to see the world’s first blog for members of the public, patients, clinicians, people in the system and system suppliers and see what others are saying about this.
I would be very keen to hear from you about the idea of “records access” and any further thoughts you may have to encourage its widespread adoption throughout the UK. We have just set out on a journey of discovery. I look forward to you joining us as we try to help each other move forwards.
Dr Dave Barrett
dr.barrett@skybluemedicalgroup.co.uk
Harnall Lane Medical Centre
DISCLAIMER - On-line Electronic Health Record Project
It is a condition of your use of the Egton Medical Information Systems Limited (EMIS) / Patient Access to Electronic Record Systems Limited (PAERS) website introduced to you by the Practice (Green Lane & Harnall Lane Medical Centres) that you read the disclaimer of liability below and accept the terms thereof. As the disclaimer affects your legal rights you should not accept the conditions of use unless you fully understand the terms of the disclaimer.
EMIS, PAERS and the Practice are not responsible for the accuracy, quality and use of information which can be accessed and viewed by a user of the EMIS / PAERS website. EMIS, PAERS and the Practice exclude all liability to the end user who may use the website and or view information using the EMIS / PAERS website in respect of all damage howsoever caused by (i) use of the website created by EMIS and PAERS thereon, (ii) viewing any information which may be accessed and viewed using the website and (iii) any other cause whether direct or indirect.
The following list are examples of information (whether accurate or not) which may be accessed and viewed by a user of the EMIS and PAERS website for which EMIS and PAERS accept no liability: information on health advice, therapy, diagnosis and or treatment in patient information leaflets and or the information contained in medical notes, consultation records and or other records and or information which may be viewed on web sites which may be accessed by and displayed on the EMIS / PAERS website. The foregoing list of examples is not exhaustive.
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