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MDU urges caution on online access to records

Beware pitfalls of allowing access to full records, and granting access to parents of 11-16s

Louise Prime

Tuesday, 21 April 2015

GP practices need to take great care to ensure the accuracy and confidentiality of medical records before they upload them for patients to access online, the Medical Defence Union has warned. It has reminded GPs of the many potential pitfalls of allowing online access, and urged them to be particularly cautious when considering whether or not to allow parents to access the records of their 11-16-year-old children.

The MDU said that although practices in England have been contractually obliged since 31 March to allow patients online access to summary information from their medical records, some practices are considering allowing patients to access their entire record online. It said many GPs have been in contact with questions about the implications of online access, so it has developed guidance addressing common queries.

Some of the most common questions that GPs have asked the MDU relate to limiting access to sensitive information, how to respond to a patient who challenges the accuracy of their record, and how to deal with parents’ requests for access to the records of their children (or children for whom they have parental responsibility).

MDU medicolegal adviser Dr Beverley Ward warned: “Making confidential information about patients available online has logistical difficulties, and practices will need to consider how to allow patients to access information securely, while being sensitive to any information which may cause distress.

“Fortunately, there is plenty of guidance available for practices and for patients but there are likely to be more queries about the accuracy and contents of records once patients begin to sign up for online access. For example, GPs may need to explain any abbreviations the records contain and will need to ensure test results are reviewed and discussed with the patient before they are uploaded to the online record.”

She added that GPs should take particular caution over allowing parental access to children’s records. She said: “For children over 16, GPs should usually get their consent before granting access to someone with parental responsibility, but for under 16s the situation is more complicated. The RCGP suggests that full access for those with parental responsibility should be automatically switched off at age 11 and a discussion arranged with the child and parents to consider the extent of ongoing access. However, the age at which a child becomes competent will vary and it will be important to keep any access by parents under regular review.”

The MDU advises GPs to consider the following when allowing patients online access to their records:

  • How patients’ ID will be verified and how the practice will record patients with online records access.
  • The need to educate patients about keeping their information or log in details secure and the implications if they share these details with others.
  • How practices will identify third party information that will need to be withheld.
  • When to allow access to a child’s records by someone with parental responsibility.
  • The need to avoid the use of abbreviations that patients may not understand.
  • The importance of giving patients the opportunity to correct inaccurate or incomplete records, but not amend content simply because they find it upsetting. 

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