Electronic Health Record

Online Electronic Health Record (EHR) Viewing System Patient Information Leaflet and Consent Form

Online Health Record Viewing System (EHR)

Our surgery offers a service which allows you to view your medical record using a personal computer (PC) and the internet. Before you can begin using the Online Electronic Health Record (EHR) viewing system we require you to register and consent to use the system.

What is the Online EHR Viewing System?

The system is a website that allows you to view your medical record over the internet from a PC. It allows you to easily and quickly view the electronic medical information held about you by the surgery.

The information is presented to you in a format that is easy to navigate and offers you links to resources such as patient information leaflets about diseases, tests, investigations, support groups and medications etc. There are also links to websites such as NHS Direct Online and Patinet.co.uk where you can find additional information to help you understand and educate yourself about what you read in your health record.

Registering and consenting to use the EHR viewing system

To be able to use the system you must have a PC with a web browser such Internet Explorer (version 6 or later) and have a connection to the internet.

You must also register with the practice and sign a consent form before you start using the system. Before you sign the consent form you should be happy that you understand what the system does, what your responsibilities are and how your data is stored. When you have had enough time to understand this you should consent by signature and hand the consent form to your GP receptionist.

Once you have consented you will be issued with a series of numbers that you must remember. They will allow you to access the system from any PC connected to the Internet. You will need to use 2 passwords. The 1st is for ordering repeat prescriptions, checking and making and cancelling appointments only. The 2nd is to access your medical records and needs to be 8 digits which can be a mixture of letters and numbers. They are case sensitive so remember whether you used upper or lowercase.  Remember the computer treats the letter O and number 0 as different characters.

Any data held by the practice concerning you is subject to the regulations laid down in the Data Protection Act (1998). The consent is between you and your surgery.

How do I use the Online EHR Viewing System?

Using your PC web browser enter the web address www.galletly.co.uk navigate to the “Services” tab and then click on “Online Appointment Booking and Prescriptions”. This will load the EMIS Access site.  You should then click on “Create your account”.  Alternatively type in the web address www.emisaccess.co.uk to access the site directly and click the link “How To Register” for full illustrated instructions to setting up EMISaccess on your HOME PC.

Once you have signed into EMISaccess you must select the ‘View Medical Record’ section which will further prompt you to enter the password specifically assigned to allow you to view your online EHR.

When you have been correctly identified the system will allow you to view the parts of your medical record as described below. Use the menu and links to view each area of your medical record. There is an online help section to help you use the system.

What can I see on the Online EHR viewing system?

The system allows you to view the following areas of your medical record:

·         A summary that gives you the most important and recent entries in your health record.

·         Consultations including: date, practitioner seen, reason for visit, history, examination, outcome, investigations, etc.

·         Medical Record showing diagnoses, investigations, and procedures

·         Allergies.

·         Patient Information Leaflets linked from the diagnoses in the medical record section.

·         Results showing all investigations such as blood results, liver tests, blood pressure etc.

·         Vaccinations.

·         Medications.

·         Letters to and from the GP.

The system also allows you to send messages to your practice using a system in EMISaccess (if your practice has enabled this).

Why have an Online EHR viewing system?

There are many reasons to provide you with access to your medical information. A few of them are listed below:

‘We want to develop a culture of openness, honesty and trust; to ensure that patients have the information they need to make informed choices; and to enable patients to become equal partners with health care professionals in making decisions about treatment and care.’ This is the response to the Department of Health from the enquiry into the Bristol Royal Infirmary Enquiry.

‘Patients have the right to see their medical records, though in practice much communication between professionals is not available to the patient concerned. Patients often do not know why they are being referred, or what is being said about them’ The NHS Plan.

This practice believes that it is important for improved patient care and education that you are involved in your healthcare as much as possible

Advantages to you, the patient:

·         No queuing to get results

·         You can check the accuracy of your medical record

·         It empowers you to become more involved in your medical care

Where is my confidential medical information held whilst I am viewing my online EHR and who has access to it?

The information you view on the online system comes from the clinical system at The Galletly Practice. Portions of this information are encrypted (this means it is very difficult for someone else to intercept and read the information) and securely sent from the GP practice system to your PC web browser.

None of the medical information that is shown on the online system is held permanently on any computer except the computer which holds the original data in your surgery.

When you log off from the online system or if a problem occurs with your computer, for instance a power failure, all your confidential medical information is cleared from the system.

Using the online system does not allow any extra people to view your medical information other than the people who would normally have access to it in the GP practice.

How will other people be prohibited from seeing my record?

To view your online EHR you have to identify yourself with passwords and PINs that only you know. Unless you reveal this information to someone else you will be the only person able to access your medical record via the online system

What if I find an error in my medical record or if I see someone else’s medical information?

If you find any errors or missing information in your medical record you must inform the practice immediately, or discuss it with your GP.  If you see someone else’s medical information you should immediately exit from the system and inform the practice.

What if I don’t want to register to use the EHR?

If you do not want to register to use the online electronic record system you can still use all the practices’ services exactly as before. Your decision not to register will not affect your treatment or your relationship with your GP practice in any way.

REMEMEBER TO LOGOUT FROM THE EHR SYSTEM WHEN YOU ARE FINISHED.

Other considerations:

Having access to their medical records via the internet has proved to be very popular with many patients.  Before signing for access to your records it is important that you look at both the advantages and disadvantages.

Advantages   J  (A patient’s perspective)

GP/Healthcare                                     The patient has an active role in their own healthcare and develops a good relationship with their GP and Practice.  This is being backed up with the ‘Choose-and-book’ option where the patient can choose which hospital they would like to be referred.

Results                                                   With access to your medical records you can check any results or letters

Access abroad                                       You may be in another country and taken ill.  You may decide to allow the doctor access to your records (a personal decision).  It might be that you forgot to order your repeat prescription and need it to be ready on your return.  You can do this by using an internet café. You usually find such facilities in most holiday complexes.  This has been tried very successfully from abroad.

Casualty or outpatients                      If you are going to see a healthcare professional in hospital you can allow them to see your records online if there is a computer in the room or print out the relevant information and take it with you. (The date will be on the bottom of the printout). This can be very helpful to the consultant.

Care in the Community                      It might be that you are receiving care at home and it is necessary for latest results of tests to be known before treatment is given.  You can check the results yourself or allow anyone else you see fit to do so.

Nursing Homes                                    If a relative is in a nursing home, and you have been given access to their records, by monitoring the ‘consultation’ section you can monitor their care.  Records of visits by doctors along with comments by the doctor will be recorded here.  This could be done from anywhere in the world.

Relatives having access                       Only if you wish you could share all your records with relatives or just part by printing the part you wish to share.  

Saving Time                                           For most people there is never enough time — doctors included.  Much time can be saved by ordering repeats via the net.  You can track the details and progress of your request before instructing the chemist to collect.  Blood results, x-rays or letters can be checked.  If they are normal it saves you time not having to travel to the surgery (can be lengthy & expensive if you don’t have your own transport).  It also leaves a free appointment allowing the doctor to see someone who is in need of an appointment.

Information for Forms                       If you need to know when you had your immunisations or what allergies you have, you can look them up. Also, you may be asked about significant illnesses.

Better understanding                         If you did not understand the conversation with the doctor or nurse, you can look at the record of that consultation. Patients have found that that makes the discussion easier to understand and remember.

                                                                You will also find that the information buttons explain technical terms for you. This can be extremely helpful.

Medication Information                     You can easily check information about any medication prescribed by clicking on the blue ‘i' button listed next to your medication in the list.  This also includes information on how to take the medication such as ‘on an empty stomach’ or ‘with food’ etc which is not always available when you receive tablets in bottles.  You can check what results mean or check a condition and some help guidelines.  There are links to support groups e.g. Diabetes UK.

Security                                                 It’s as safe as internet banking IF you keep your passwords secure.  You wouldn’t leave your bankers card and pin numbers lying around (particularly at work) and then wonder how someone managed to withdraw money from your account.  Don’t leave your passwords where they can be found.  This may also include at home if you don’t want family members to view your records.  Don’t use obvious ones such as names, birthdays or anniversaries etc.

Disadvantages   L

Forgotten History                                There may be something in your history you don’t want any family members to see.  It might be information you had put to the back of your mind and are now confronted with it!

Complex information                         The record is designed to be used by doctors for doctors. There will be abbreviations and technical terms. However, most patients understand most of what they read and the information buttons linked with problem titles offer detailed explanations. Please ask if you do not understand

Test Results                                          Results can be difficult to understand. Results may be abnormal and cause you to worry

                                                                What to do!

Ring the surgery and ask for telephone consultation

If out of hours

Ø  Don’t look at the results if you are prone to worry

Ø  Wait until the surgery opens before checking

§  Speak with NHS direct

§  Ring surgery for out of hours number

§  Ring A&E only if you are really bad

 

Remember had you not had access you would not have know the results until either the doctor/practice/contacted you or you rang for the results.

 

3rd Party Info                                        You might want to tell the doctor something about your spouse/partner/child etc in confidence. 

•          If the doctor records the information and the patient then sees this it could cause problems.

•          If the doctor doesn’t vital information may get lost or forgotten

•          The information may be malicious and again cause problems

Children                                 When is a child not a child?

Some may be 12 year old going on 20 while others could be 18 year old going on 10 year.  At what age do they have their own passwords?  What about a teenage girl who wants contraception but doesn’t want the parents to know?

The practice will have a policy on dealing with this issue.

Unknown Issues                  There are many unknown areas that may arise.

FAQ (Frequently asked questions)

•          Passwords?

–         Case sensitive (upper case and lower case – it makes a difference)

–         Difference between O or 0

–         If you leave passwords lying around then no it’s not secure

•          Identity Theft?

–         No address or NHS or National Insurance number given on screen

–         Only obtainable by reading letters

•          What if I mess it up?

–         No matter what you click you can’t alter it.

–        You can cancel appointments

–        You can order repeat prescriptions and you are given a chance to check it before submitting and can leave a message with your request

•          What if I am seeing a doctor and there is no computer in the room?

–        It can easily happen.  If you know you are going to see a doctor then take a print out with you.  This could include any of their letters to your GP and any recent test results

•          What if the doctor I am seeing objects?

–        Then be polite, and apologise

–        You bought them to assist the doctor not antagonise them

What to Do Next

Carefully weigh up the advantages against the disadvantages.  Consider are there other issues that have not been answered for you?

It’s up to the individual to decide if they want access and not other members of the family.

If you are seeing a solicitor regarding Power of Attorney for a relative it might be a good idea to ask the solicitor to include access to medical records.

If any of the disadvantages are a problem for you then record access may not be for you.  The treatment you receive or the relationship with your doctor will not be affected in any way.  You could still use the online ordering of repeat prescriptions and cancelling appointment facilities.

Being able to choose to have access to records is for the benefit of the patient and it is necessary to apply for such.  You may wish to discuss this further with the doctor or nurse.

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