TAKING RECORD ACCESS FURTHER

Dr Brian Fisher MBE

Co-director of PAERS Ltd

Lead for myRecord project

ACHIEVEMENTS SO FAR

• Improved safety

• Change in relationships

• Increase in efficiency

• Expanding practice capacity

“I have been able to have some control over my illness rather then allowing it to control me - a very very important

thing when dealing with long term illness/pain.”Vanessa

“I have a chronic disease and feel a real partner in the management of my health. Whether I am at home or abroad I can monitor information and share it

with any other health professional involved in my care. I would be lost without it now!”

Ingrid

The patients who were offered it as our trial group were those on methotrexate.  It reduced the number of phone calls to reception for copies of results and made patients much more responsible for their own care, which they liked.

Practice manager

PEI – AS A RESULT OF RA

Agree/strongly agree that I am more able to:

• 14% cope with life                              • 27% understand my illness• 22% cope with my illness• 36% keep myself healthy• 45% I am more confident about my health• 50% help myself

Howie J A comparison of a Patient Enablement Instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations. Family Practice Volume 15, Issue 2 Pp. 165-171

269/48/24

SELF-CARE

• 62% understood better what had been discussed in consultation.

• 77% understood their condition and managed it better

Bhavnani V, Fisher B, Winfield M Seed P How patients use access totheir electronic GP record—a quantitative study . Practice 2010; 0:1–7

MEDICATION AND BEHAVIOUR CHANGE

• 42% More likely to take their medicines.

• 64% RA helped patients follow lifestyle advice.

WORKLOAD - CLINICIANS’ EXPERIENCE

• 80%: easily integrated into work processes

• 80%: no change in writing records

• 13%: consultations a bit shorter, rest no differencePagliari C • Shand T • Fisher B Embedding online patient record access in UK primary care: a survey of stakeholder experiences J R Soc Med Sh Rep 2012;00:0. DOI 10.1258/shorts.2012.012009

CLINICIANS’ AND MANAGERS’ EXPERIENCE

• 73% would be willing to recommend to another practice

• No security/confidentiality concerns

• 53% of clinicians felt RA facilitated shared decision-making

ANNUAL SAVINGS TO A 10000 PATIENT PRACTICE - 30% OF PATIENTS USING RA AT

LEAST TWICE A YEAR

Doctor appointments 2520 SAVED

Nurse appointments 1110 SAVED

HCA appointments 420 SAVED

Other appointments 630 SAVED

Telephone calls 7950 SAVED

LIMITATIONS

• Patient is passive• Clinician is passive• Makes limited use of

the possibilities of record access

I-PATIENT

• Interactive Web 2.0• Begins to harness the

record for patient benefit

• Enables others to interact with the patient

• A single place where patients can get relevant info

NEW FEATURES FOR PRIMARY CARE

• Practices and CCGs can send messages to patients – Targeted, automated social marketing– Only to the patients you want– Public health benefits

• Messaging to and from the practice• Apps for self-care

– Other agencies– Can enhance efficiency, self-care– Safe and secure

NEW FEATURES FOR PATIENTS

• i-google design

• All transactional services on one page

• Gadgets - patients can choose the health news they want to see

• Social networking

• Phone apps

IN THE FUTURE

• QOF reminders for patients

• Patients adding their own data

• Pharma research opportunities