Using electronic health records to improve patient care (2) Understanding personal medical records

10 January, 2023

Patients successfully recognized and found between 50% and 100% (as I remember) the markers of their GP quality outcome framework processes for diabetes, hypothyroidism, high blood pressure and another, asthma, I think, when we gave them their notes *** on a CD and the QOF markers that they should expect to see completed and recorded for their best care in their notes.

*2002* - HRI project with Merton and Sutton patients e-mail own glucose and blood pressure results to records.

*2002* - West Pennine HA project to give 109 patients own E.H.R (Now 220 patients have medical records on floppy discs for use at home/on holiday Records have been translated into other languages)

What patients wanted 1

Access from own PC via internet.

Patients felt the pilot should have been given a minimum of 6 months to run.

Easier access. Fingerprint reader rather than pass code.

Add their own date e.g. blood pressure, cholesterol and weight

Medical glossary linked to the E.H.R.

Print out, floppy disk or CD to have when way from home.

What patients wanted 2

Audit trail.

Blood group.

Hospital letters.

X-ray results

Blood test results

Control of who has access to the record.

G.P’s to break bad news before it appears in the record.

Here are the current GP Quality Outcome Framework quality markers by which GPs are paid. They were simpler in 2002 but similar and we gave them to patients to look for in their notes. This could equally be done by patients or any ongoing longstanding disease protocol and for patients with multiple morbidity. A culture of proactive audit and cooperation rather than competition or conflict for this to work is the most beneficial.

Patients with diabetes with blood pressure of 140/80 mmHg or less total cholesterol is 5 mmol/L or less

Have a record of an albumin:creatinine ratio test in the preceding 12 months

With a diagnosis of nephropathy (clinical proteinuria) or micro-albuminuria

are currently treated with an ACE-I

The IFCC-HbA1c is 59 mmol/mol or less in the preceding 12 months a record of retinal screening in the preceding 12 months record of a foot examination and risk assessment

Referred to a structured education programme within 9 months after en had influenza immunisation in the preceding 1 August to 31 aged 40 years and over with no history of cardiovascular disease and without moderate or

severe frailty currently treated with a statin

With diabetes and a history of cardiovascular disease (excluding haemorrhagic stroke) currently treated with a statin

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