On the BBC Health website Dr Graham Easton’s blog gives us a GP’s view the use of electronic patient records in doctors surgeries.

He is a staunch supporter, and provides us a useful reminder of the inadequacies of the previous system which relied on ‘a pile of little brown cardboard packets on my desk – ‘Lloyd George’ notes – stuffed with folded letters, test results and illegible hieroglyphics. Some patients needed three or more packets stuck together with sellotape.’

As well as the usual benefits of electronic records (the speed of finding records, the legibility of writing) Easton describes the way that his computer checks up on him. It can remind him of the possible side-effects of a drug, check it’s compatible with the patient’s other medication or send reminders when a patient is due for tests.

Interestingly, he also highlights the use of patients’ records for auditing within the surgery.

Unlike with paper records, it’s very easy for us to check and audit our performance to find out how we’re measuring up against national standards. For example, how many of our patients with high blood pressure have their pressure adequately controlled?… At the moment I’m finding out how our practice is doing when it comes to treating fungal toenail infections – a common problem with clear evidence-based guidance on how to test for and treat it. The computer found all the relevant cases in the blink of an eye (it would have taken days of searching before).

There’s been a lot of attention to the national Secondary Uses Services database, which makes patients’ (anonymous) records available for purposes not directly related to patients’ care, such as auditing and research. However, GPs seems to be doing this kind of thing on a much smaller scale, with arguably many fewer risks to patient privacy.

Even as a self-proclaimed supporter of computerised medical records, Easton is fully aware of the downsides. Many of these are problems with computers in general. They break. And as well as saving time overall, we’ve all had computers waste our time as well, which is particularly infuriating in GPs surgeries where time can be so tight. The question of patient security and privacy also looms large.

But Dr Easton is worried that computers can have a more profound effect on the relationship between doctor and patient.  Doctors with ‘one – or both – eyes on the computer screen’ can miss subtle bits of information and give the impression they’re not listening. The computer may work well to keep doctors in touch with the system – by sharing notes, comparing performance or dispensing advice – but it seems they can also act as a barrier between the doctor and the patient.