A single patient record is a sole source of health information about a person, that’s available to any health professional that’s helping with their care.
The main benefit of a single patient record is improving the continuity and quality of healthcare. With access to a patient’s clinical notes from all the professionals that have been involved in their care, the healthcare worker in that moment can make more informed decisions in relation to their care.
“All the information is synced and readily available,” explains Semble’s VP of product, Sara Fikrat. “There’s no risk of missing information about the patient or a chance of losing anything. This is critical to safely delivering care. It’s also vital to the patient experience: repeating your details can be frustrating and being handed over to the next step in your care with no context can be harmful for some.”
For those with chronic conditions, for example, a single patient record could be life-changing. Moving doctors can often become a burden when records aren’t transferred, leaving it up to the patient to detail their history, medications and dosages to their new practice, which can be timely when you need treatment quickly.
An integrated, more holistic approach to patient care helps improve the safety of patients within their care journey, and provides a consistent experience for both the patient and practitioner. But it can also improve the quality of data analytics, which can then be used to advance our health services, giving professionals the tools to keep patients at the centre of everything they do.
How available is a single patient record?
At the moment, caregivers can’t always access the records of care that their patients have received elsewhere. Because data can be held across so many places – their GP’s office, two different hospitals they’ve visited, and more – often there’s no complete picture of a patient.
At each stage in the care process, every detail received by a professional is key, and could affect how care continues from that point. Without that information, healthcare workers are missing pieces of a patient’s puzzle, and must settle with an educated guess.
Creating a unified patient record can be a tricky process, however. (It should be noted that in general, the NHS and the private sector do not share data unless to help the NHS or for research purposes.)
| Sara Fikrat VP of Product at Semble |
In theory, the transfer of data in a single sector shouldn’t be too complicated. But the NHS is made up of hundreds of different organisations, many of which use a different technology and software to do their job. Each system has tightly controlled silos, which means healthcare workers can’t always access data even if the patient gives consent.
But it’s something the NHS have been working on. In 2022, an NHS project was approved to incorporate millions of personal digital records into a Federated Data Platform (FDP), one of the biggest health data platforms in the world. This would help healthcare professionals move to a 360 view of patient care. If data from all over the industry fed into one accessible system, it could also help planners show trends across the population.
Are there any drawbacks of a single patient record?
The main concern arises with data privacy and security. This is highly personal information – a single patient record would be the birth-to-death documentation of a person and their health.
The NHS holds the richest source of health data we have in the UK – but that also makes it incredibly valuable (experts market it at around £9.6bn a year). Tech giants could use this data to continue the development of health tech – but who’s to say this information couldn’t be used in other ways, particularly by those who might have an agenda.
In November 2023, tech giant Palantir won a contract with the NHS to create the Federated Data Platform. Palantir is headed by tech mogul Peter Thiel, a Trump supporter who has funded anti-abortion candidates and invested in anti-birth control start-ups.
There have been fears of what Thiel’s personal beliefs mean for this professional relationship. Furthermore, there is a worry that this could lead to people opting out of providing their data, decimating trust in the NHS. However, NHS England have said that it, not Palantir, will control how the patient data is used. It also points to explicitly contractual safeguards “to prevent any supplier gaining a dominant role in NHS data management”.
What are the dangers of not having a single patient record?
Without 360 visibility on a patient record, it could be argued there’s a lack of accountability. Information can be lost, interactions can be missed. Or in the case of Ian Paterson, malpractice can fly under the radar, proving to be fatal.
In 2017, breast surgeon Ian Paterson was sentenced to 20 years in prison after carrying out thousands of unnecessary and unapproved surgeries on breast cancer patients over 14 years.
The Paterson Inquiry, which investigated the misconduct, found that one of the many reasons he was able to continue operating the way he did was because patients’ records were not accurately recorded:
“Paterson’s notes were generally of poor quality and contained insufficient detail to allow the reader to determine what procedure had been undertaken… Some patients gave evidence that Paterson had lied in the letters he sent to GPs… [his] notes were only available to his breast care nurse.”
Without an electronic patient record, paper copies of Paterson’s notes often went missing, and were able to be destroyed without consequence. Paterson would also take patient notes between NHS and private hospitals “informally, rather than a matter of routine”. This case has highlighted how not sharing accurate information in an appropriate way can put the patient in harm’s way.
| Sara Fikrat VP of Product at Semble |
Beyond the risks of a fragmented patient record, at its most basic this disconnect makes everything frustrating and slow. The concept of a single record is key in what experts call ‘whole-person care’: a strategy in which doctors treat patients by looking at the full spectrum of their needs.
“A smart single record means you have a 360 view of a patient, their care and their interactions with the clinic,” says Sara. “All information should come from relevant sources: labs, pharmacies, admin teams, and the medical record inputted by the patient themselves. This data should be available to all those involved, not just the person who requested the information.”
At its core, a single, integrated patient record is integral for care co-ordination, and can be used to make accurate, effective care decisions. It can be done – and successfully has been, in some areas. The journey to it will likely be fraught, but necessary for the improvement of care.