GPs concerned by TPP data sharing system

Tags: Community Confidentiality consent CSC GPs Informatics PCT SystmOne TPP

08 Jul 2008

GPs have raised concerns about TPP SystmOne’s new data sharing model which Connecting for Health says is currently being reviewed before further roll-out.

SystmOne release 3 will change the way data sharing works for SystmOne users as well as introducing Role Based Access Controls.

The current system means clinicians make decisions about data sharing using six different privacy levels. Release three introduces an Enhanced Data Sharing Model which means all patients must choose whether their information is “shareable” with all other SystmOne units with which they are registered or “private”. Patients may also opt to have some individual events as “private” while leaving the rest of their record shareable. The default option for patients will be “private”.

Nottinghamshire, where approximately 50% of the 185 practices are SystmOne users, was due to have release three rolled out earlier this spring. However Nottinghamshire Local Medical Committee chief executive Chris Locke said that the LMC took the “unprecedented step” of writing to all three PCT chief executives to express its concerns about the plans for data sharing which he said involved a 12-week roll-out programme.

Locke told EHI Primary Care: “A number of our GPs and practice managers expressed significant concern about the data sharing and confidentiality aspects of it as well as practical problems of sharing data with the community staff.”

He also said GPs were also faced with obtaining consent from every patient which he said would be “a huge piece of work for practices”, identifying which information patients wished to withhold and which they were happy to share.

Locke said the LMC held a meeting with Nottinghamshire’s Health Informatics Service and was initially told there had been no problems with the pilot site in Lincolnshire.

He added: “Since then a message has come through that there were a number of issues in North Lincolnshire and that there will be a moratorium on any further data sharing.”

Locke said existing data sharing arrangements would continue as to withdraw them could damage patient care. However he said the LMC was pleased the roll-out had been delayed.

He added: “We are not against the principle of data sharing for the patients’ benefit and we are committed to making this technology work.”

Release three introduces Role Based Access Control for SystmOne users and Locke said this had also raised concerns among GPs about business continuity issues. Access rights would no longer be set at practice-level creating potential problems in particular circumstances such as when locums were working at the practice or when access needed to be changed outside support desk hours.

A spokesperson for Connecting for Health said the “pioneer phase” for release 3 was now complete. She added: “There is a period of review and lessons learned from this exercise before agreement to roll the release out further is agreed.”

She added: “The RBAC exercise is complete and will be rolled out as part of every migration to, or new deployment of, TPP R3. The impact on users will be minimal.”

The original plan for release 3, as outlined by CSC in February, was for roll-out to be complete by summer 2008.

Fiona Barr

Reader's Comments

more information..

maryhawking@tigers.demon.co.uk

08 Jul 08 22:07

It would be very helpful if there was more information on the reasons for changing access to systems and publicly available impact assessment - especially if future plans were discussed when practices were advised by the PCTs to change systems and the plans were known at that time. I gave a presentation on the problems of clinical governance in single records at the PHCSG (www.phcsg.org.uk - click on conferences the summer conference program then Information Governance; issues around a single health record – stream 2 day 1. this has a slide on the access and sharing controls in TPP R3.01. at a high level it looks ok - but I can see it would be difficult to implement. There *is* a tension between sharing information - and TPP is the only system to go down the route of a single record - and maintaining data quality, confidentiality and legal liability. *Is* there anything available on line? PS CfH have commissioned work on aligning GPG with shared records. Which I deeply appreciate.

Where is Patient Involvement ?

Adrian.Kearns@westmidlands.nhs.uk

09 Jul 08 09:07

I recall when Output Based Specification for the new all encompassing IT systems for Healthcare was being reviewed there talks of access to the Summary Care Record and Patient Demographic Details for Patients through media including Sky Digital TV.

One of the many concerns of the public is what information is held on me, who has access and what control do I have.

Surely the devlopers and Grand Poobah's at CfH must have comsidered the burden in administration for obatining patient consent ???

Is this not a missed oppurtunity to have allowed access for patients and allow patients to self administer the Six security levels.

Please don't give me all the "... how do we make it secure..." etc as many many millions e-bank, e-shop and manage utilities and investments etc.

We need to challenge the assumption that patients do not have access to technology or the skills to manage some of there own care records.... lets start crediting the Public with some maturity and intelligence and start involving them in the Natonal Care Record which they hav paid many billions for.

This will reduce the burden on providers of Primary Care for a start.

In defence of the HIS

09 Jul 08 09:07

'Locke said the LMC held a meeting with Nottinghamshire’s Health Informatics Service and was initially told there had been no problems with the pilot site in Lincolnshire'.

Anyone who actually attended the meetings and impact assessments will know that this wasn't the case. All were informed that the HIS had not received Lessons Learned and were eagerly waiting to find out exactly how this impacted on NE Lincs Practices and services. The approach the HIS took in informing practices and services was done in a professional manner. Its always the case that those that get slated are those in the line of fire. As the saying goes ' Don't shoot the Messenger'.

Just my care team

ian.swanson@blueyonder.co.uk

09 Jul 08 11:07

I find the lack of the mention of legitimate relationships in any of the articles or comments on data sharing very worrying. It is these that decide who can look at a record while role based access decides what can be looked at, providing TPP are implementing them. It is as if this layer of the security model is ignored or not understood, and people assume that shared data is open to anybody.

Double Standards

13 Jul 08 17:07

Yet again, more double standards from General Practice where CfH systems are involved. Ask about CfH shared systems and patient choice, confidentiality are suddenly issues. EMIS offers EMIS web for a locality of Practices to share records and all is well. I will have my cake and eat it please !