Medical records

[Mike Sales]

Is the simple answer that NHS IT systems were not designed to enable this important conversation between my medics?
The specialist does write (on paper, through the mail) to my GP, summarising the consulation and I get a copy of this. If the GP needed, say, a copy of an X-ray, could I request one from the hospital and carry it to the surgery?

[Jdsk]

Is the simple answer that NHS IT systems were not designed to enable this important conversation between my medics?

That's about right, but it isn't the full answer.

The specialist does write (on paper, through the mail) to my GP, summarising the consulation and I get a copy of this. If the GP needed, say, a copy of an X-ray, could I request one from the hospital and carry it to the surgery?

Do you mean the images or the textual report?

Jonathan

[Mike Sales]

Do you mean the images or the textual report?

Jonathan

The images.

[Mike Sales]

Is the simple answer that NHS IT systems were not designed to enable this important conversation between my medics?

That's about right, but it isn't the full answer.

Jonathan

Is this the all too usual government incomtetence in these IT schemes?

[Jdsk]

Do you mean the images or the textual report?

The images.

There isn't a right way of doing this, but it's not uncommon for patients to move images on 'phones, USB sticks etc.

But don't make any assumptions about your GP's ability to display, manipulate or store the images in her information system.

And are you sure that your GP wants to see them?

Jonathan

PS: Happy to discuss privately if that would help.

[Mike Sales]

Do you mean the images or the textual report?

The images.

There isn't a right way of doing this, but it's not uncommon for patients to move images on 'phones, USB sticks etc.

But don't make any assumptions about your GP's ability to display, manipulate or store the images in her information system.

And are you sure that your GP wants to see them?

Jonathan

PS: Happy to discuss privately if that would help.

Thanks for your explanations.

[Psamathe]

Do you mean the images or the textual report?

The images.

There isn't a right way of doing this, but it's not uncommon for patients to move images on 'phones, USB sticks etc.

But don't make any assumptions about your GP's ability to display, manipulate or store the images in her information system.

And are you sure that your GP wants to see them?

Jonathan

PS: Happy to discuss privately if that would help.

In my example above (MRI not being shared), I have offered to the consultants to get the raw MRI data/images but they said that the radiographers use exceptionally expensive display screens to carefully examine the images - screens they don't have. So they don't really want the images (they don't have the screens) but want the radiographers to report on when they should have reported on. But my situation the MRIs are head and ear structures and it's the ears they are concerned about rather than some significant sized thing.

I've not asked but believe it would be fairly easy for me to get the raw MRI images (take 10 days) - it's a tick box option of the Subject Access Request form the hospital uses. I've not asked as they'd be of no use to me and just waste hospital time getting them.

Ian
Edit: nb: when I have asked for e.g. the reports from the hospital they send them on disk (they encrypt the files on a CD they post and they seperately e-mail you the unencrypted code for that CD/DVD).

[prestavalve]

...radiographers use exceptionally expensive display screens to carefully examine the images - screens they don't have. So they don't really want the images (they don't have the screens) but want the radiographers to report on...

This is utter nonsense: a 65" 4k TV costs £800 and would be more than enough to do the job. Your inner ear could be a foot long on a screen such as that.

[Jdsk]

...radiographers use exceptionally expensive display screens to carefully examine the images - screens they don't have. So they don't really want the images (they don't have the screens) but want the radiographers to report on...

This is utter nonsense: a 65" 4k TV costs £800 and would be more than enough to do the job. Your inner ear could be a foot long on a screen such as that.

There's a lot more to optimal viewing than resolution. Reporting by radiologists is preferably done in rooms with managed brightness, multiple monitors. grey scale optimisation, planned ergonomics etc. This is not the case for most clinicians in either primary or secondary care.

However the original business cases for PACS typically underestimated how much clinicians value direct viewing of the images.
https://en.wikipedia.org/wiki/Picture_a ... ion_system

Jonathan

PS: And interpretive reporting is predominantly performed by radiologists rather than radiographers.

[prestavalve]

There's a lot more to optimal viewing than resolution. Reporting by radiologists is preferably done in rooms with managed brightness, multiple monitors. grey scale optimisation, planned ergonomics etc. This is not the case for most clinicians in either primary or secondary care.

My GP has a comfy swivel chair and a dimmer switch in their office.

[Jdsk]

I'm confused so if you want hospital and NHS to share scans, blood tests- but not sell data to companies, which do you do as done the online one.

This is a very important point.

The short answer is that the project under discussion does not support direct care such as you describe. it is only for "planning and research".

Update on GPDPR:
https://www.nhsdatasharing.info/caredat ... 9final.pdf

includes:

Most importantly, I can confirm today that, while we are continuing to work on the infrastructure, and communication for the project, we are not setting a specific start date for the collection of data. Instead, we commit to start uploading data only when we have the following in place:
● the ability to delete data if patients choose to opt-out of sharing their GP data with NHS Digital, even if this is after their data has been uploaded;
● the backlog of opt-outs has been fully cleared;
● a Trusted Research Environment has been developed and implemented in NHS
Digital;
● patients have been made more aware of the scheme through a campaign of engagement and communication.

My emboldening.

Jonathan

[Psamathe]

I'm confused so if you want hospital and NHS to share scans, blood tests- but not sell data to companies, which do you do as done the online one.

This is a very important point.

The short answer is that the project under discussion does not support direct care such as you describe. it is only for "planning and research".

Update on GPDPR:
https://www.nhsdatasharing.info/caredat ... 9final.pdf

includes:

Most importantly, I can confirm today that, while we are continuing to work on the infrastructure, and communication for the project, we are not setting a specific start date for the collection of data. Instead, we commit to start uploading data only when we have the following in place:
● the ability to delete data if patients choose to opt-out of sharing their GP data with NHS Digital, even if this is after their data has been uploaded;
● the backlog of opt-outs has been fully cleared;
● a Trusted Research Environment has been developed and implemented in NHS
Digital;
● patients have been made more aware of the scheme through a campaign of engagement and communication.

My emboldening.

Jonathan

I believe this isn't the first time NHS Digital have had to significantly re-think plans but only in response to public outcry. Makes you wonder about the organisation (or its management). They spend our money on developing these systems and it's then the public privacy reaction that actually makes them think about what they are doing - not good.

Ian

[axel_knutt]

I was a little surprised that my GP and the local hospital where I am being treated could not share my scans and x-rays online.
Different systems apparently!
This proposal to share my records with other bodies seems to show mistaken priorities.

It's worse than that. England and Scotland have two completely separate systems, if you live in England and fall ill whilst on holiday in Scotland they have no way to access your records:

Caldwell's worth a follow, he's a Consultant at Oban (formerly Worthing), and tweets a lot about what a shambles the NHS bureaucracy is.

[mattsccm]

I do wonder how many people, like me, wonder "what the hell are you on about?" Online what? NHS records what? Options what?
Never heard of any of it.
A little bit of me wonders what the fuss is about. If you use a service maybe you agree to everything that comes with it. Just a thought.

[Oldjohnw]

I do wonder how many people, like me, wonder "what the hell are you on about?" Online what? NHS records what? Options what?
Never heard of any of it.
A little bit of me wonders what the fuss is about. If you use a service maybe you agree to everything that comes with it. Just a thought.

If you are ill I am wondering what choice you have but to use this particular service.