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Day 27: Appointment with anaesthetist, eight days before surgery, at Fastrack Hospital. I mentioned that I had a heart murmur and had had an echocardiogram 18 months ago in my regular hospital, 'H Hospital'. This, very properly, worried him, and he spent the next hour on the telephone trying to dig the record out of the other hospital.
That seemed to me a waste of his time – and mine. With a proper national clinical database, or, dare I say it, with proper "connecting for health", a few keystrokes to enter a pin number and about one minute should have been enough. Or, indeed, I could argue that the fact of my heart murmur should have come to him automatically, with the rest of my record, before I had even entered his surgery.
In the end he organised an echo and consultant report at a nearby private hospital, which must have cost Fastrack and the NHS a pretty penny.
Now, as a patient, I don't care a damn whether the record of my echo is accessed on a central 'spine', or by direct request to the hospital holding the data, or to my GP's record. All I ask is that my data, wherever it may be, is available to clinicians caring for me at the click of a mouse. But, it seems that this happy outcome is still years away.
I notice that when patients are surveyed about whether they insist on 'opt-in' to the Summary Care Record, they are supremely laid back about the whole argument. But some doctors and academics, for the last seven years, have carried on a continuous guerrilla war against any attempt to provide national care records.
I sympathise with some of their concerns – particularly about the inherent iffiness of monster centralised databases, and the worries of HIV sufferers.
I suspect a cultural problem, buried deep in the British medical psyche. They were told at medical school that doctor/patient confidentiality was at the heart of their profession. This does not seem to me to reflect the reality of 21st century medical practice. Today, patients move around, and get treated in many hospitals.
Prudent anaesthetists, like my chap at Fastrack, find it necessary and commonplace to try to check out the treatment their patients have received in other hospitals. He never asked me whether I had opted in or out to access my record. Nor was it sensible for him to do so. Patients like me welcome their inquisitiveness, but deplore that they have to jump through hoops to get at our records.
A week ago, I came across a blog by a Fastrack patient, who was distressed because her treatment was being held up, because her regular hospital in the Midlands had not responded for a month to a Fastrack doctor's request for details of previous treatments. So, it's not just me. Record-sharing between hospitals is a hit and miss affair.
I have a nasty feeling that, because it has always been so difficult for them to access their patient's records, many British doctors don't even try, and actually prefer to fly by the seat of their pants. They don't like being confused with facts.
And yet, as a humble patient, I ask how can they make sensible clinical decisions without knowing everything relevant about me? The technology is there to find out, but it is not being used. I read of 7000 patients a year dying of "inappropriate treatments" in the NHS. Many of these deaths, I suspect, are because doctors have not probed their patients' "backstory". I don't want to be one of them.
Next time: The Patient from Hell has his operation, and looks round his ward for signs of technical progress since his last spell in hospital.
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