Patient record access – A spur to innovation

I’ve been involved in one of the working groups which are part of the RCGP-Led Online Patient Access Project,  which has been funded by DH to help deliver on the Government’s promise to deliver online access for all to their GP records and a range of associated transactional services by 2015. As part of this work I attended a meeting tyesterday (25 Oct 2012) between the project and interested suppliers from the Intellect Healthcare Group.

This was an open meeting with selected press present so unlike other parts of my work with the project I’m free to talk about what went on. However, it’s not the core subject of the meeting I want to talk about, but how the meeting illustrated the potential that is unleashed when you start talking about opening up systems.

First some background. GP record access has been pioneered for some years by EMIS  working with Paers  and delivers full read-only record access along with support for transactional services (appointment booking, repeat medication requests, secure communication). So far only a handful of pioneers have turned on full record access while many more have opened up one or more transactional service. The two other significant GP suppliers also now offer transactional services and have full record access ready to go and it seems likely that the RCGP project, combined with sticks and carrots from Government , aimed at GPs, along with demand from patients will mean that the services become available to all GP practices during 2013, although I think it remains to be seen how many practices will opt to grant  full online record access and how strongly they will promote the services they choose to offer to their patients.

Government, however are not content with just getting basic services delivered by the incumbent GP suppliers, but have much more exciting plans to see core systems opened up to encourage third parties to develop a range of innovative services that will deliver record access and transactional services in a variety of ways.  There is an expectation that some of these new services will simply provide a slicker interface or access in ways more suited to particular patient groups while others will integrate patient record access in to products with broader scope (particular as part of services designed to help patient and their informal care networks manage long-term conditions) and finally there is a hope that some new things will emerge that those of us currently involved have not yet imagined.

From today’s meeting it seem to me that hopes for innovation are likely to met or exceeded if Government can get the technical stuff right and tweak incentives to ensure an opportunity for viable business models is created.

My reasons for reaching the opportunistic conclusion are based on what infer from examining the list of attendees and what was said at the meeting.  There were about 35 companies represented at the meeting including the large and small, many were primarily IT companies but a significant number were organisations offering a range of clinical and health management service. Interestingly, only one of the incumbent GP suppliers was represented and they had little to say.

The focus from the companies present was unsurprisingly on what might be available to them as a result of the records access project, but it was clear that they were also interested in the broader opportunities for innovation created for them by the opening up of systems, the data they contain and the transactions they manage.

The potential here is massive and I think this was not lost on the officials present from the Dept. of Health and the NHS Commissioning Board. I hope they will take the buzz from the meeting back to their masters as evidence that their commitment to open-data and open-systems does have the transformational power they hope for.

However, as you might expect there is a caveat. Catalysing the transformation requires more than just opening systems and data it requires action and investment to create an technical, cultural and contractual environment  which will allow the reaction to proceed at pace. Technically, this is about infrastructure and infrastructural  services (like identity management) and the right approach to standards see my blog: Standards are a barrier to innovation Culturally it’s about selling the benefits of transparency and managing legitimate fears about the “Daily Mail” effect. Commercially it’s about addressing procurement issues and creating an ecosystem in which sustainable business models can be built around openness.

There is much in what’s happening to encourage us but Government needs to act to ensure that the excitement and innovation they have created delivers sustainable benefit.