WHO Medication Safety Webinar Series - First Webinar, 08 February 2022 (2) Sharing of medical records

9 February, 2022

[Re: https://www.hifa.org/dgroups-rss/who-medication-safety-webinar-series-fi... ]

I joined the WHO The WHO Global Patient Safety Challenge: Medication Without Harm Webinar Series webinar yesterday from 12,0 GMT to 13,30 GMT, then the European Health Observatory webinar "State of Health in the EU: Stakeholders’ perspective on digital innovation in health care and rethinking health workforce strategies". from 13.30 to 15.00. I also joined a UK Medical, Defence Union webinar on "Duty of Candour" a week ago. (There are both professional regulatory and statutory duties of candour on UK doctors to inform patients when serious harm is caused when clinical care goes wrong.)

I missed the first half of the European Health Observatory webinar but noticed that the hour that I followed was not really about digital innovation but about supporting and finding staff - with non-specific references to a desire for a cross border European health record.

The WHO webinar was also related to staff training and education interagency cooperation and difficulties caused when different service providers with different normative regulatory standards passed "care" from one to the other.

Some of these highlighted difficulties might be minimised by different parties sharing their recorded work. Breach of confidentiality is a fear of clinicians and patients yet I suspect that death or disability is a bigger fear. One of the patients on our 2006 Department of Health Copying Letters to Patients said "Doctors use confidentiality like a knife against patients". We waste so much time and money repeating questions, results, examinations and tests and repeating narrative and episodic information gathering that it feels ridiculous in a much lauded joined up age of information technology.

Medical care is a resource - like coal, gas, water, cars, and it is not as freely available in some settings as in others. What CAN resolve some medical resource issues is the sharing of work that has already been done and by so doing not repeating the resource of work. By this I mean the sharing of medical records, living guidelines and learning organizations.

I was a trainee in a UK Vocational training Scheme for family medicine in between 1976 and 1979. What surprised and slightly disappointed me as I spent six months in different specialties in the city of Leeds was that no notes were shared between organizations. When I worked in A and E I could not see the family doctor notes of patients with multiple morbidities and medications because of "Confidentiality". When I was in family practice I could not see the notes that my colleagues had made when one of my patients had been in A and E or admitted to hospital.

When I was doing paediatrics I could not see the health visiting and community health notes, including tetanus, measles, rubella and other vaccination details. When I was doing obstetrics on patients with diabetes, heart disease, or even cancer, I could not see the diabetes, heart nor cancer drugs. As health systems try to catch up, they really must share more "work" resources - that is work that has already been done and recorded at great expense and that should be shared for safety, better clinical outcomes and resource efficiency.

Here is alink to one country's plans and processes of digitization they will be very similar in other countries. https://www.nhsx.nhs.uk/

"NHSX moves on

After three years leading the digital transformation of health and social care as NHSX, we are integrating with the Transformation Directorate at NHS England.

Our mission will remain - to drive the digital transformation of the NHS and social care. And our status as a joint unit of NHS England and DHSC continues as well.

We have made huge progress over the past three years, emphatically through partnership with NHS Digital, NHS BSA and frontline NHS and social care organisations. There is now a long list of achievements to NHSX’s name which you can learn more about in this latest blog. Almost all of them have been delivered in partnership with NHS Digital and our other partners.

Matthew Gould, CEO"

and I highly recommend this public explanation about why data is being processed in this way. Public engagement is always the last thing that "techy" health IT professionals think of or understand as they are not immersed in contact with individuals or groups of the public.

https://youtu.be/YLi9gh7RyLA

HIFA profile: Richard Fitton is a retired family doctor - GP, British Medical Association. 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