Online services: 'Patient-powered' health will make care safer and more efficient

Practices should grab the opportunities provided by online patient-facing services with both hands, says Dr Brian Fisher.

There are many benefits to online patient-facing services for both practices and patients.

Online patient-facing services include booking appointments, ordering repeat prescriptions and viewing the coded GP record. Secure messaging is also available through the systems, but practices can choose whether to switch that on or not.

So far as record access is concerned, patients can currently see coded information on medication, allergies, illnesses, immunisations and test results. Practices are free to share records from consultations if they choose – and there are good reasons for doing so.

The GMS contract makes it clear that practices have to help anyone who wants it to sign up for patient-facing services. Practices can no longer refuse patients unless you judge patient- facing services to be dangerous to them or you.

The contract also requires practices to promote patient-facing services, including record access. And I think that NHS England will expect every practice to increase their number of patients using online services up to certain targets.

The benefits of promoting patient-facing services

Evidence shows there is mutual gain for practices and patients.

  • Better communication and trust.1
  • Safer care, as patients can share data across the system – and abroad. Sharing with consultants, with carers, with parents – and with no information governance problems.
  • Time-saving for practices and patients. Patients don’t have to call for results or other simple information. Many appointments can be avoided. If 30% of patients looked at their full records at least twice a year, about 10% of appointments and hundreds of telephone calls can be saved.2
  • Probably better compliance and patients making more informed decisions.3

How to make the most of patient-facing services

  • Proactively offer online access to your patients with long-term conditions. They are most likely to benefit and the practice is most likely to save time. Practice nurses may be best at this. Emphasise the above benefits
  • Make sure receptionists have the tools to make this as simple as possible at the desk. They can be found here. Practices should also give written information to patients to warn them of potential risks
  • Encourage appointment booking and repeat prescription ordering – that will also save you and your patients time. Receptionists should be encouraged to recommend this – unless the practice is committed to total telephone triage.
  • Do you want to offer more than the contractual obligations? Free text and letters as well as coded information? In general, the more you share, the more benefits you and your patients will gain.

I believe that patient-powered health will make care safer and more efficient and online services can help deliver this. Grab this opportunity with both hands

  • Dr Brian Fisher is a GP in London and is the clinical and strategy director of Evergreen Life, the company behind i-Patient is available to EMIS practices and offers patients online services. Dr Fisher was previously the co-director PAERS which has been acquired by Evergreen Life.


  1. Bhavnani V, Fisher B, Winfield B How patients use access to their electronic GP record—a quantitative study. Family Practice 2010; 0:1–7 doi:10.1093/fampra/cmq092
  2. Fitton C, Fitton R, Hannan A. The impact of patient record access on appointments and telephone calls in two English general practices: a population based study.  London Journal of Primary Care 2014; 6: 8–15
  3. Ross SE, Moore LA, Earnest MA. Providing a web-based online medical record with electronic communication capabilities to patients with congestive heart failure: randomized trial. Journal of Medical Internet Research 2004; 6(2): e12.

Photo: iStock

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