Tuesday, May 06, 2008

Report of Evaluation of Summary Care Record Early Adopter Programme

An interesting report has been published today into the evaluation of the Summary Care Record (SCR) Early Adopter Programme. It highlights many of the difficulties which have been encountered and makes recommendations to improve for the future.

The evaluation team led by Trisha Greenhalgh at University College London discusses criticisms of the programme focusing on "implementing a technology rather than a broader and more developmental focus on socio-technical change". They also make comment about the ethical and moral considerations inherent in the "current ‘hybrid’ consent model for the SCR, which is widely seen as overly complex and unworkable (and which many GPs and Caldicott Guardians see as unethical), and consider alternative models, notably ‘consent to view’, that have been shown to be acceptable and successful in comparable programmes" in Scotland and Wales. This was despite the fact that few of the patients in the pilot area reported strong feelings about whether they had a SCR and low levels of "opt out".

The report also criticises an "outdated model of change – centrally driven, project oriented, rationalistic, with a focus on documentation and reporting, and oriented to predefined, inflexible goals", and argues for "more contemporary models of change (which are programme-oriented and built around theories of sensemaking, co-evolution and knowledge creation) include soft systems methodology, technology use mediation and situated action".

The full (138 page) report is available from, and although I've only read the executive summary so far I think it should be compulsory reading for anyone involved in electronic health records.

Further commentary and discussion is taking place on the E-Health Insider site under Urgent review of SCR consent model recommended and elsewhere. It will be interesting to see if the lessons learned will be put into practice.

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  • Thanks for the summary of and pointers to the report, Rod. As you point out, the report is long (138 pages) and will take a while to digest.

    In addition to the E-Health Insider report and commentary, there is a report on the BBC News website ( >>> ) and also on Tony Collins' Computer Weekly blog ( >>> ).

    Tony comments that "...Computer Weekly has learned that significant changes were made between a draft report by researchers at University College, London, and the approved final report. The final report softens or omits some of criticisms of the government and NHS Connecting for Health [CfH]..."

    By Blogger Peter, at 11:04 am  

  • Your tiny url-link is broken :)

    It can be found via this page:

    By Blogger Derek Hoy, at 11:00 am  

  • Thanks Derek, Link now fixed. Rod

    By Blogger Rod, at 11:06 am  

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