Finding Ethical Principles and Practical Guidelines for the Controlled Flow of Patient Data

1999 ◽  
Vol 38 (04/05) ◽  
pp. 345-349
Author(s):  
R. Draper ◽  
I. Hamilton ◽  
M. Rigby
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Controlled Environment ◽  
Control Mechanisms ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Vulnerable Patients ◽  
Practical Guidelines ◽  
Controlled Flow ◽  
Data Subject

AbstractThe application of computing to health care, and particularly to electronic patient records, offers major benefits but raises issues of confidentiality and of potential misuse. Sound access control mechanisms are therefore important, but most models focus upon informed consent by the data subject. This raises challenges in mental health care, and for other vulnerable patients including those comatose, and the severely ill and temporarily distressed. Published algorithms which are used to control record access within a controlled environment therefore have value, as a means of ensuring an open and informed, yet ethically sound, solution. The paper describes the background and issues, and gives an example of such an algorithm.

scholarly journals How is patient activation related to healthcare service utilisation? Evidence from electronic patient records in England

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feifei Bu ◽  
Daisy Fancourt
Keyword(s):  
Health Care ◽  
Healthcare Service ◽  
Patient Activation ◽  
Outcome Variable ◽  
Service Utilisation ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Emergency Admissions ◽  
Gp Visits

Abstract Background There is increasing awareness of the importance of patient activation (knowledge, skills, and confidence for managing one’s health and health care) among clinicians and policy makers, with emerging evidence showing higher levels of patient activation are associated with better health outcomes and experiences of health care. This study aimed to examine the association between patient activation and a wide range of specific types of healthcare service utilisation in England, including GP and non-GP primary care, elective and emergency hospital admissions, outpatient visits, and attendances at the Accident and Emergency department. Methods Data were derived from linked electronic patient records collected by primary and secondary healthcare providers in North West London between January 2016 and November 2019. Our analyses focused on adults (18+) with a valid Patient Activation Measure (PAM). After excluding patients with missing data, we had an analytical sample of 15,877 patients. Data were analysed using negative binomial regression and logistic regression models depending on the outcome variable. Results Patients had a mean activation score of 55.1 and a standard deviation (SD) of 17.7 (range: 0–100). They had an average of 5.4 GP visits (SD = 8.0), 26.8 non-GP visits (SD = 23.4) and 6.0 outpatient attendances (SD = 7.9) within a one-year follow-up. About 24.7% patients had at least one elective admission, 24.2% had one or more emergency admissions, and 42.3% had one or more A&E attendance within the follow-up. After accounting for a number of demographic and health factors, we found a linear (or proximately linear) association between patient activation and the number of GP visits, emergency admissions and A&E attendance, but a non-linear relationship between patient activation and the number of non-GP visits, the number of outpatient attendance and elective inpatient admission. Conclusions This study has provided strong empirical evidence from England linking patient activation with healthcare service utilisation. It suggests the value of supporting patient activation as a potential pathway to ease the burden of healthcare system.

Assessment and management of vulnerable patients

2019 ◽  
pp. 141-148
Author(s):  
Sophie Behrman ◽  
Dorcas Dan-Cooke
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Inpatient Care ◽  
Discharge Planning ◽  
Management Strategies ◽  
Holistic Treatment ◽  
Complex Patients ◽  
Vulnerable Patients ◽  
The Uk

Staff working on mental health wards are well accustomed to assessing and managing vulnerable patients. With the current organization of mental health care in the UK, where only 5.7% of patients in contact with mental health services received inpatient care in a year, only the most unwell and/or complex patients are seen on mental health wards. These patients may well have numerous vulnerabilities, which require assessment and management as part of the holistic treatment of the patient during their admission and for discharge planning. This chapter discusses who these particularly vulnerable patients are, examines what sort of vulnerabilities patients might experience, and suggests possible management strategies.

scholarly journals Reasonable adjustments for autistic adults

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S81-S81
Author(s):  
Nazish Hashmi ◽  
Conor Davidson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental State ◽  
Service Users ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Adults With Autism ◽  
Increased Risk ◽  
Disability Status

AimsTo embed the use of reasonable adjustments for adults with autism within in mental health services.ObjectivesThe objectives of the project are as follows: To identify how many service users with a diagnosis of autism are under care of local mental health servicesIs there evidence that reasonable adjustments were considered for these service usersIf identified as needing reasonable adjusments is there evidence of such adjustments being madeMethodWe looked at service users with an established diagnosis of autism under care of Leeds and York NHS foundation trust to ascertain if reasonable adjustments have been considered. The audit is based on guidelines provided by Think Autism-department of health statutory guidance 2014. This is based on autism act 2009.Data were collected for 30 cases in mainstream mental health services undr care of various teams including inpatient and community.ResultIt was identified that in only 2/30 cases reasonable adjustments were considered and agreed upon. Only 1/30 service users had a disability status updated on electronic patient records. None of the service users had a hospital passport or reasonable adjustment care plan completed.None of the records had “good evidence” of reasonable adjustments.These findings point to a wider issue for the trust as well as natioanlly as it indicates that autism is not being adequately taken into account for patients accessing our services. Due to the lack of reasonable adjustments adults with autism are potentially at increased risk to disengage leading to deterioration in their mental state and increase in risks.ConclusionThese findings point to a wider issue for the trust as it indicates that autism is not being adequately taken into account for patients accessing our services. Due to the lack of reasonable adjustments adults with autism are potentially at increased risk to disengage leading to deterioration in their mental state and increase in risks.We recommend training in autism for all healthcare professionals in the trust to improve their understanding of autism, including making reasonable adjustments.We also recommend review trust procedure about recording diagnoses and disability status on electronic patient records. We recommend that the reasonable adjustments section on care director is more prominent and easily accessible.We recommend that an ‘autism flag’ is prominent on patient records to alert staff to the presence of autism

scholarly journals Using data linkage to electronic patient records to assess the validity of selected mental health diagnoses in English Hospital Episode Statistics (HES)

PLoS ONE ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. e0195002 ◽  
Author(s):  
Katrina Alice Southworth Davis ◽  
Oliver Bashford ◽  
Amelia Jewell ◽  
Hitesh Shetty ◽  
Robert J. Stewart ◽  
...  
Keyword(s):  
Mental Health ◽  
Data Linkage ◽  
Hospital Episode Statistics ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Hospital Episode ◽  
Mental Health Diagnoses ◽  
Using Data
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