Two stories that have come to our attention this week highlight a tricky aspect of electronic patient records which has been rather pushed to the sidelines.

Herefordshire is celebrating becoming the first county to integrate their NHS and council IT system in a great step forward for more joined-up public services.

Hereford’s ICT director Zack Pandor said:

If you look at the interaction for someone who has had a stroke, they will have a range of requirements. They may need social care services, housing, support from GPs and specialist acute services. To join up these systems and services creates a range of opportunities that are truly immense to provide seamless care to citizens and patients.

While Herefordshire so far has not integrated their health records with other areas of the council, the Isle of Mann is taking it that next step for their children’s services. Programme director at System C, the IT providers for the project explains:

The bespoke system will enable the 35 social care practitioners, working across five different teams in the Children & Families department, to access a shared care record system in order to manage the large volume of information they receive over the course of a case. The system will also be integrated with other departments in the Social Services Division, including the Resource Centres for disabled children and the multi-agency Youth Justice Teams. When appropriate, information will also be shared with both the Primary and Community Health Services on the Island.

Many have been arguing for a long time that a person’s health, housing and care needs are not separate but intimately connected, and service providers need to communicate better to create more rounded care.

However, whil the Isle of Man’s status as a self governing British Crown Dependency means it has more freedom to experiment with the new system, we are still some way off a shared record system here on the mainland.

Should we be following suit?

A hospital sharing a record with a GP seems very natural to most of us. But how would we feel should our health details were accessible to the housing services or care workers? And if they were, would we want these workers to undergo the same confidentiality training that health professionals currently do? Many are worried that from here it is a close step to records being shared with the police or immigration services.

As so often happens with electronic patient records, great opportunities for improvement come up against equally legitimate concerns about protecting patients’ privacy. Steering a path between the two is proving no easy task.