Is "sharing" really "caring"?

The Telegraph recently published an article based on the announcement that high street pharmacies will be given access to NHS medical records in a move that has provoked privacy campaigners. There are arguments both for and against this move, which I have listed below:

Con

• The process: A large part of the argument against this move is the way in which national policy has been implemented. The test sample on which this policy was based came from just 15 patients. This is very difficult to justify and unfortunately adds to the already significant level mistrust in policy makers.
• The hard sell: There is concern that giving access to sensitive data to large commercial high street pharmacies will lead to the targeting of vulnerable patients with hard sell tactics. Despite the likes of Tesco stating that they would never use this data to market to customers, campaigners are not convinced.
• Confusion over guidelines: The results of the small sample found that pharmacy staff were confused about getting consent from patients before accessing sensitive data. This issue needs to be addressed to avoid data breaches and misuse due to human error or lack of training.
• Data security: Another concern from patients is that loyalty cards may be linked to personal medical records. The number of healthcare data breaches in the past leads to concerns that as medical data would now be bundled with other personal data held by the retailer, the combined value of this data would become more attractive to hackers.
• Confidentiality: One of the most fundamental arguments against this move is that there still remains a large portion of the population who simply do not want to share their data. The NHS has tried to calm these concerns with the insistence that pharmacy staff gain permission before viewing this data but undoubtedly a lot will still be unhappy that they have access to it in the first place.

Pro

• A necessary step: The ultimate goal is for a fully integrated healthcare ecosystem whereby insurers, providers, pharmaceutical companies and indeed the patients work together to improve the health of individuals and the nation. There are a lot of benefits that come from sharing, accessing and utilizing data (especially in mass) but with data kept in silos, this is simply not possible.
• Results of the sample: Although the sample used was incredibly small, the results “proved extremely beneficial”. These benefits have come from individual sites and so if used on a national level (a la population health), economies of scale would be achieved as well as leveraging analytical capabilities to improve healthcare delivery.
• Personalized service: Enabling access to medical data will promote a personal and customized service for the individual patient. A personalized service which aims to improve the health of the population will ultimately also lead to cost savings for the healthcare ecosystem. The bargaining power (although often criticized) of large retailers such as Tesco could also lead to lower pharmaceutical costs.
• Less pressure on family doctors: NHS England claim that sharing medical data with high street pharmacies will ease pressure on family doctors. Doctors will benefit from better processes as well as having a clear view of what pharmaceutical products have been purchased. It's also important to consider that the flow of data should not be one way and can benefit providers as well as pharmacies.
• Reduction in improper medication: A comment on the article also pointed out that some patients may struggle to remember the types of medication they are taking as well as the dosages. With high street pharmacies able to access your file (with your consent), this will reduce the number of instances of patients purchasing and taking the wrong medication or under/overdosing.

Regardless of the criticisms of this rollout, with the right regulations, safeguards and guidelines in place, many commentators believe the personal and social benefits will be become apparent very quickly.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. The Telegraph, Boots, Tesco and Superdrug to get access to NHS medical records, 09 Aug 2015, http://www.telegraph.co.uk/news/health/11790711/Boots-Tesco-and-Superdrug-to-get-access-to-NHS-medical-records.html