For years and years NHS leaders have dreamt of having a single computer system accessible by all staff that would allow doctors to get clinical details about any patient, anywhere in the country, at anytime of day. A comprehensive patient note system would reduce bureaucracy and duplication, plus enhance safety and speed of treatment. It would solve one of the most frustrating aspects of the NHS: its tortoise-like pace of transferring information internally.
The confidentiality of a doctor-patient relationship is extremely important. However, schemes that aspire to this NHS IT nirvana will inevitably threaten this. The Government care.data scheme last year was guilty of this; it proposed uploading all patient information to a central computer database and selling this on to Research bodies, Universities or possibly Private Companies. This was an ‘opt out’ scheme and many people understandably opted out as soon as they understood the proposal. Care.data was withdrawn due to the Government being unable to answer a multitude of ethical and practical questions. Undeterred the enthusiasts changed tack and aimed at a more realistic target and this time they have potentially hit it.
This new proposal is called the Medical Interoperability Gateway (MIG). If a GP Practice in Devon opts into this system it will be allowing doctors in designated places (eg. local hospitals, Devon Doctors on Call) to enter their Practice computer system. If the patient gives permission an Out of Hours Doctor will be able to look at their GP notes. It is the equivalent of a Bank giving its Secure Vault Access Code to some trusted colleagues to help customers when the Bank is shut. The colleagues can enter the Vault but only open the customer’s individual safety deposit box when the customer is standing beside them.
The MIG has safeguards that protect patient confidentiality whilst also enabling patients to consent to sharing of their notes when they wish. The process is two way: the notes a doctor makes in A&E on a Sunday night will be viewed immediately by their GP on Monday morning. Speed, efficiency, safety and confidentiality. It is working well in other parts of the country and is being rolled out in Devon this summer. Wyndham House plans to opt into this scheme.
It is important to reiterate that a doctor can only access your notes via the MIG if you give formal consent at the time you are with them. You have a key to your notes, they have a key but both are needed at the same time. However if you prefer that your notes are not in the accessible ‘vault’ please let us know and we will ensure they are labeled as such.