This section explores the types of shared patient records and approach to clinical safety.
Types of Shared Patient Record
We recognized two types of shared patient record currently in use or being developed:
- Single Shared Record (SSR) where two or more organisations use the same patient record of prime entry. The SystmOne Electronic Patient Record is the only example in use to date (March 2021).
- A Composite Shared Record (CSR), where care organisations contribute fragments from their own patient records of prime entry to a single multi-organisational read-only record for use by other care organization treating their patients, e.g. their general practices. Many of the Local Health Care Records (LHCRs) being constructed at regional level take this form. A (significant) number of these are referenced in the Final (reference) report of the Shared Record Professional Guidance  written by the RCGP in 2011.
The approach taken
We decided to take a clinical safety approach to capturing our concerns. So a modified Hazard Log was created during the discussions and then shared and developed further. The assessment of a risk level was deliberately left out as that was not felt to be part of this exercise. The log was not intended to be exhaustive, but to highlight areas of concern for further discussion and mitigation.
The next section of the report describes the issues we discovered, and the Conclusion section describes the clinical concerns that emerged from these issues.