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 /48/24Family PracticeVolume 15, Issue 2

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 to their 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 difference Pagliari 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 /shorts

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 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