IT competence is key to patient safety

I have just heard to my horror that the DoH is planning to abandon its requirement for practices to demonstrate IT competence before being allowed to upload electronic summaries to the spine.

Instead of passing the Information Management and Technology Directed Enhanced Service (IM&T DES), practices will merely have to acquire paperless accreditation, which needs no demonstrated competence.

With no need for practices to demonstrate the soundness of their electronic recording, the DoH will then claim that the vast majority of practices are ready to send patient summaries to the spine - and so justify Connecting for Health and its wasted billions. Yet abandoning these important standards will put patients' lives at risk. In their absence, large numbers of incomplete or inaccurate summaries will be uploaded.

This situation is ridiculous and unsafe. Although the UK is a world leader in medical software, it doesn't necessarily follow that users will use IT properly or consistently.

There is still no formal training in the use and upkeep of the computerised medical record. Indeed, many clinicians imagine that simply writing down their findings, with a suitable Read code attached, is sufficient. It is not - particularly where just a summary of the record is shared.

How many summaries miss important items, or are full of trivia? How many depend for their completeness on free text - which won't be uploaded? How many omit substantive diagnosis, yet include procedural entries such as 'Diabetic monitoring'?

Does current medication include all hospital-prescribed or community-given drugs? Are discontinued drugs removed immediately? Are sensitivities up to date and recorded in a manner fit for sharing?

Housekeeping the medical record is a skill which has both to be acquired and practised - which is why IM&T DES accreditation is genuinely important. In its absence, how can any doctor trust a spine summary? Medico-legally, who will take the blame when a doctor relies on a summary that proves dangerously inaccurate or out of date?

Dumbing down IT standards appears to be a cynical ploy to make the DoH look good in the electorate's eyes - while at the same time putting their health at risk.

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