Evidence submitted by the Royal College
of Radiologists (EPR 35)
1. The Royal College of Radiologists (RCR)
has approximately 7,000 members and Fellows worldwide representing
the disciplines of clinical oncology and clinical radiology. All
members and Fellows of the College are registered medical or dental
practitioners. The role of the College is to advance the science
and practice of radiology and oncology, further public education
and promote study and research through setting professional standards
of practice.
2. This response outlines the RCR's views
on what information should be held in the Electronic Patient Record
(EPR) and emphasises that it should build on and enhance the current
roll-out and implementation of the national Picture Archiving
and Communications System.
What patient information will be held on the new
local and national electronic record system
3. The Electronic Patient Record (EPR) should
consist of a Summary Care Record containing a very brief summary
of the event, time and place, with hyperlinks for those with the
appropriate access permissions to more detailed on-line information.
4. The types of events that should be recorded
on the summary are:
— Previous major surgery.
— Previous inpatient episodes.
— Information on allergies, including
alerts relating to contrast media.
— Existing chronic conditions.
5. We have debated what level of content
would be appropriate for logging on the summary care record. It
was felt that any significant episode which could impact on the
patient's future healthcare management would be useful and every
inpatient or daycase episode of hospital care is essential.
The date that the record was last updated should
also be noted.
6. The summary should then link to more
detailed information including the patient's radiological reports
and images and, in the future, cumulative exposure to radiation.
7. It is important to ensure that the Electronic
Patient Record builds on and enhances the current roll-out and
implementation of the national Picture Archiving and Communications
System (PACS). PACS enables the electronic storage and transfer
of images. The benefits of this are numerous.
— From a patient perspective, it prevents
images being lost or unavailable for consultations, therefore
speeding up diagnosis and treatment. It also reduces the need
for repeat imaging, meaning that patients need not be subjected
to unnecessary radiation.
— From a clinician perspective, it
allows for a much more efficient use of time and quicker reporting.
As the images will be available across sites immediately, multidisciplinary
discussions can take place at once, even if participants are in
different places. It also allows the networking of services through
hub and spoke type models.
Therefore, it is vital that the EPR incorporates
the benefits that PACS is bringing to patients in terms of safety
and efficiency of care.
Whether patient confidentiality can be adequately
protected
8. It is vital that patient confidentiality
is maintained. However, it is equally important that this is not
detrimental to patient care. All those who need access to a patient's
records to diagnose or treat them, must be able to do so easily
and efficiently.
How data held on the new systems can and should
be used for purposes other that the delivery of care
9. The data could be useful for research,
audit and teaching purposes.
Professor Janet Husband
President, The Royal College of Radiologists
15 March 2007
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