The BMA has expressed strong reservations about the Conservative Party’s plans for a review of the NHS Information Technology strategy announced yesterday.
The review sets out plans to scrap the central "spine" of the government’s £12.5 billion National Programme for IT in which a national network, built by BT will hold all the data.
Instead they propose that trusts could choose their own information systems.
Companies such as Google which runs the Google Health site in the US and Microsoft which runs Health Vault in the US could hold the data and make it much more accessible to patients who could input information like blood pressure or cholesterol levels.
The BMA says the review leaves many questions unanswered, and it has concerns about the possibility that restrictions could be placed on healthcare professionals’ access to records, which could have implications for the safety of patients, particularly children.
Dr Vivienne Nathanson, the BMA’s head of science and ethics, said:
"There have been major problems with the national NHS IT programme and we support the principle of greater local decision-making.
"However, it is unclear where the funds would come from to ensure the smooth integration of new online patient records with the systems currently used by hospitals and GPs. Many trusts in England are waiting for new electronic systems to replace paper-based processes. This review does not provide a solution to that problem."
Commenting on the proposal to allow patients to edit their medical records online, Dr Nathanson said:
"The BMA strongly supports the principle of patients controlling their own medical records. However, we have concerns about the security of web-based systems, and the implications of data being held by the private sector. There would need to be very strong safeguards and an accurate audit trail making it clear what changes or deletions had been made to records and by whom. All NHS IT systems must reach the highest possible standards for privacy, accuracy, security, and useability.
"We are concerned by the suggestion that healthcare staff could be restricted from accessing important clinical information. Clinicians need access to records in order to do their jobs. If the information they have is incomplete - for example because pathologists have been prevented from entering test results - there could be implications for patient safety, as well as a negative impact on valuable health research.
"In a situation where a child was at risk of abuse, we would be very concerned about information being removed from their records by a family-member."
And Richard Holway, chairman at IT analyst house TechMarketView, said the approach being considered by the Conservatives "has many merits".
But many of the costs of the NHS IT programme have already been committed and a cancellation would probably trigger higher costs by way of compensation to existing providers.
Doctors needed a guarantee they could access their records, he said. And many elderly patients, or those who were very ill, may face difficulties accessing online patient records.