“I did it all on a phone”: The hotline changing health outcomes in Malawi (2) Health advice by phone and personal medical records

6 December, 2022

When I took over a singlehanded family practice in 1993 (my busy partners were not motivated to create a patient centred medical practice) I was on call 24 hours a day 46 weeks of the year for two years. I had a son aged 12, a daughter aged 10 and my wife was working during school terms as a school librarian. (Who I get most of my information ideas from!). The pressure of being on call of the time was intense and insupportable although this was how Family doctors worked in the 1920's, 1930's and 1940's. (Private doctors' success is a measure of Accessibility, Availability and Ability - and in that order.)

Onset of labour, appendicitis, stroke, heart attack, meningococcal meningitis, epileptic seizure, broken bones do not respect bank holidays, night time nor doctors' holidays. Neither do exacerbations of complex co-morbid health issues. Access to advice in hours and out of hours for these conditions can be augmented by phone services, online chat lines and for the receiving health assistant by access to the patient's medical record. Remarkably, a recent paper in the UK researched and reported on UK universities undergraduate education about digital health. (Ref 1) Not one medical school had a complete undergraduate curriculum on digital health.

Many practical and economic factors prevent face to face immediate encounters. Remote non face to face encounters also have the advantage of reducing CO2 emissions for travel and of saved time and cost for patients. (Ref 2.)

1. Using electronic patient records: defining learning outcomes for undergraduate education - PubMed (nih.gov)


2. The impact of patient record access on appointments and telephone calls in two English general practices: a population-based study. - Abstract - Europe PMC


The European Health Data Space is planned to make similar improvements in health care access. Ref 3

3. European Health Data Space (europa.eu)


In order to unleash the full potential of health data, the European Commission is presenting a regulation to set up the European Health Data SpaceSearch for available translations of the preceding link. This proposal

- supports individuals to take control of their own health data

- supports the use of health data for better healthcare delivery, better research, innovation and policy making and

- enables the EU to make full use of the potential offered by a safe and secure exchange, use and reuse of health data

HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data

Email address: richardpeterfitton7 AT gmail.com