Transforming health care: stories of changemakers across the world (3)

25 March, 2022

One of the key changes in healthcare mentioned in the stories of change makers across the world is "- breaking down of harmful professional hierarchies"

surprisingly, perhaps, one of the findings on an **** Artificial Intelligence program on an American hospital was that the artificial intelligence that was backed up to the hospital EHR reduced the professional hierarchy. The AI system was linked to the hospital EHR to diagnose patients likely to deteriorate within the next 12 hours. The AI algorithms p-rovided the list to both nurses who were looking after the patients and to the doctors in real time. The system provides a facility for a "structured huddle" (virtually, I guess) as the nurse and doctor perform their own separate tasks. Previously frontline ward nurses had not been empowered to transmit their concerns about deteriorating

patients to doctors but he shared EHR and shared "Mental Model" overrode this difficulty.

The shared digital record record is universal within English General Practice (GP) and the record is becoming a national one utilised by family doctors, nurses, health care assistants, secretaries, administrators and other health care professionals. From April 1st 2022 it is mandatory for new entries to the GP digital record to be shared with patients who have opted into record access ^^^^(Over 30% of the population have the app that allows this).

Patient access to their

(**** This was described, yesterday, in a webinar on Artificial Intelligence by the The NEJM Catalyst which brings health care executives, clinician leaders, and clinicians together to share innovative ideas and practical applications for enhancing the value of health care delivery.)

(^^^^ Access to patient records through the NHS App - NHS Digital

<https://digital.nhs.uk/services/nhs-app/nhs-app-guidance-for-gp-practice...

may also help break down professional hierarchies.

"From April 2022, patients with online accounts such as through the NHS App will be able to read new entries in their health record. This applies to patients whose practices use the TPP and EMIS systems. Arrangements with practices which use Vision as the clinical system are under discussion. From April 2022, the GPIT system configuration is being changed so that existing online users have access to their future, or prospective, health information entered after this change is made. New online users set up after this date will also receive this level of access by default.

General practice will be able to customise or remove access for individuals if having access to future, or perspective, GP health information is inappropriate.

This is an NHS England and NHS Improvement programme supported by NHS Digital.

The change supports NHS Long Term Plan commitments to provide patients with digital access to their health records. It means GPs will need to consider the impact of each entry, including documents and test results, as they add

them to a patient’s record. Patients will not see personal information – such as positive test results – until they have been checked and filed, giving clinicians the chance to contact and speak to patients first.

We also aim to enable patients to request their historic coded records in 2022 through the NHS App.

Research shows that increasing numbers of patients want easy access to health information about them, including 80% of the 26 million NHS App users. Better access supports patients as partners in managing their health, and can help reduce queries to general practice such as on negative test results and referral letters.

The change also supports existing GMS contract

<https://www.england.nhs.uk/wp-content/uploads/2020/03/update-to-the-gp-c...

requirements to promote and offer online patient access to all future information, unless exceptional circumstances apply.

This change will apply to the NHS App and all other approved patient facing services apps

<https://digital.nhs.uk/services/gp-it-futures-systems/im1-pairing-integr...

that provide record access, for example Evergreen, Airmid, SystmOnline and Patient Access."

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