1) The end to software vendor lock-in in Britain:

http://www.ehiprimarycare.com/news/item.cfm?ID=2546

GP2GP reaches 500th mark ahead of time
19 Mar 2007     
Connecting for Health has implemented GP2GP at 500 practices, almost a
month before the planned deadline of 31 March 2007.

GP2GP record transfers between practices caused by patients moving or
switching practice. The service starts when a practice accepts a new or
returning patient onto the practice list to receive treatment and ends
when the Electronic Health Record (EHR) is transferred from the previous
practice into the new GP clinical system. Once the patient is accepted,
a message is sent to the previous practice requesting a copy of the
patient’s EHR - as long as the originating practice is GP2GP enabled.


2) Scotland already has something similar, now for England. Details of
authentication procedure for patients are interesting.

http://www.ehiprimarycare.com/news/item.cfm?ID=2543

Starting gun fired for Summary Care Record roll-out
15 Mar 2007     Click to see the
9 reader comments below

The government's ambitious plan for a national system of electronic
summary care patient records (SCR) will begin trials tomorrow at two GP
practices in Bolton, in the north-west of England.

Approximately 14,500 patients will have a summary of the GP record,
containing details of name, address, medication history, serious
illnesses and allergies, uploaded to a national database unless they
choose to opt-out during after an eight week consultation period
beginning today. Letters and leaflets explaining the programme will go
out in the next few weeks.

By July, eight weeks after the end of the consultation phase, Bolton's
out-of-hours provider and A+E department will be able to view the
summary record.

Professor Mike Pringle one of the two clinical leads behind the project
told E-Health Insider: "This is the starting gun for the early adopter
programme for the Summary Care Record." He said he expects a total of
seven PCTs to be involved in the programme by the end of the year.

The first two practices are Keardley Medical Centre and the Kirby, Page,
and McMillen practice, Bradshaw Brow.  The first of the practices use
InPractice Systems GP software, while the second uses iSoft GP software.
 Other practices, initially from Bolton PCT, will follow over the next
few months.

Dr Liaqat Natha from Kearsley Medical Centre, said: "There are huge
potential benefits from making patient records available to all staff
caring for them, through the secure NHS network."

The creation of the summary care record, which will be accessible to
authorised clinicians working in A+E departments, and GP out-of-hours
providers, is intended to be of value particularly as an emergency care
record. A similar project is already being rolled out by NHS Scotland,
while a summary care record project has been running in Hampshire and
Isle of Wight for some time.

The DH says the national database of summary patient records will
provide the basis for safer treatment in all care settings, reduce
duplication and lost records, saving time and money.

Patients will be able to choose whether they wish a summary record to be
created for them, whether they want it to be shared, and be able to
change their mind at any time. Individuals will also be able to securely
view their record online.

As the SCR develops it will also record details of each patient's
encounters with different parts of the NHS, providing different
clinicians treating them, including their GP, with a complete overview
of care they have received.

Connecting for Health, the NHS IT agency responsible for the project,
stresses that this summary record will not replace the detailed patient
medical records held by GPs and hospitals – which will remain the
medico-legal record. CfH says that the electronic record will enjoy
higher levels of security than online banking.

Professor Pringle stressed that the subsequent roll-out programme would
be based on the experience at the first pilot sites. "The evaluation
team will be there throughout the early adopter phase."

Professor Pringle told EHI there were now no deadlines for the full
roll-out of the project. Guidance issued to all strategic health
authorities last month said that following the 'early adopter phase' now
underway there should be a full roll-out across England of the SCR by
the end of 2008.

"The end of 2008 is not a target. There is no target for this," said
Prof. Pringle. "By the end of the year we expect to get a pace that is
sustainable. We are not going to rush it."

With the patient consultation beginning today in a blaze of local and
national publicity, patients will have eight weeks to decide whether
they want their record loaded onto the database, plus whether they want
their summary record to then be available to suitably authorised
clinicians. Unless patients of the two initial practices choose to
opt-out by the end of the consultation period, a summary record for them
will be  created automatically.

"Our advice to patients is that you decide whether there is a summary
record and you decide whether that summary record is shared," said Dr
Braunold. She said that once they had decided they were happy to have a
summary record created and uploaded to the national database they can at
any time decide who and when it is shared with the functionality acting
as "a consent to view button". Sealed envelopes will not form part of
the early adopter phase.

Asked how many patients CfH thought would opt out Professor Pringle
said: "Based on the experience of Scotland and Hampshire and Isle of
Wight we expect very few will want to opt out."

Once the first two practices have loaded up records, other practices
from Bolton PCT will follow in their footsteps. Initially the summary
record will be available to clinicians working for the local
out-of-hours provider, with the local A+E department to follow.

CfH's other GP clinical lead, Dr Gillian Braunold, told EHI that in the
near future patients will be able to access their summary record using
the online patient portal HealthSpace. "We won't do it with the first
two practices but soon afterwards."

Patients will have to securely register to use HealthSpace, and provide
a form of ID. They will then get an entrance card, which has a 5x5 grid
of numbers on it and PIN number by post. To access their summary record
they will have to provide a grid reference from the entrance card and
their PIN.

Dr Braunold stressed that the experience of the early first two adopter
sites would be carefully monitored and inform future roll-out plans.
"We're doing this very slowly and carefully, so we can be fleet of foot."

She added: "I'm very proud of my colleagues in the first two practices
going live who are also taking on the pain of going through all the
business processes involved. This is about changing the way people work"
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