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Comment on NHS Summary Care Record by PJ

PJ — Sat, 13 Mar 2010 20:50:46 +0000

I’ve elected to remain opted in (although I do have a very dull medical history). In my everyday practice on acute medical and surgical takes I have seen many patients who would have benefited from us having access to their SCR – most patients, surprisingly I think, seem to know remarkably little about their past medical history, particularly their surgical history, and in my trust it takes a day or more to get a patient’s medical notes (the notes stored for that trust only, anything from elsewhere is very difficult to obtain, including GP data) assuming they haven’t been misplaced or lost somewhere on the way. I can think of at least one death in the last few months that might have been avoided if details of past medical history were known.

I have no doubt that, as with many other big government IT projects, there will be massive cost overruns and huge useability issues, but in theory I think it is a good idea.

Comment on NHS Summary Care Record by uberVU - social comments

uberVU - social comments — Sat, 13 Mar 2010 06:42:25 +0000

Social comments and analytics for this post…

This post was mentioned on Twitter by psychiatrist: Is blogging – NHS Summary Care Record http://bit.ly/9cWULV…

Comment on BMJ: A series of unfortunate events by Rod

Rod — Thu, 11 Mar 2010 15:30:51 +0000

Hi. Very good. You say that 90% of suicides have a psychiatric disorder. Do you mean inferred or have at some time in the past attracted a formal psychiatric diagnosis? And if at some time diagnosed what proportion were being treated and currently seen in a clinic? Do you have stats for completed, incompleted, failed, reported intent and the various gestures?

If the suicide rate is increasing and 90% have had a formal psych diagnosis that suggests that psych diagnosis could be the cause of some of the suicides. I don’t buy the idea that the “increasing pressures of modern life” are increasingly triggering the genetically susceptible or that advances in psychiatry are enabling more and valid diagnoses.

The kid in the case study may not ever have had a mental illness but his notes might indicate otherwise to support whatever treatment he had before. So if you are going to admit him for God’s sake don’t confirm a diagnosis and drug him as soon as he get’s through the door.

Comment on BMJ: A series of unfortunate events by Dr. Lawrence Kindo

Dr. Lawrence Kindo — Thu, 11 Mar 2010 07:47:22 +0000

A very useful article indeed. I bet it would have taken quite an effort to research such a masterful article. Good work!

Comment on BMJ: A series of unfortunate events by Frontier Psychiatrist

Frontier Psychiatrist — Sat, 06 Mar 2010 10:52:05 +0000

Hi Claire,

When you see someone in the NHS a record of your meeting and any treatment should be kept and this will be as detailed as the person you see thinks fit. It is key to retaining patient trust that someone’s details are kept confidential to within the people who have a professional interest in their care. With respect to your case I don’t know the full story clearly, but from what you say your family members appear to have engaged in a gross invasion of your privacy.

Your options as I would see them are:

- ask to be seen under a pseudonym
- inform your family members that this will not be tolerated and that you will make a complaint if it happens again
- go private

Comment on BMJ: A series of unfortunate events by Claire

Claire — Fri, 05 Mar 2010 21:11:12 +0000

Hi, I’m hoping you can take the time to answer this question because I can’t find the answer on google. If I see a psychiatrist (or psychologist) how much information is included in my medical records? I would like to ask my GP for a referral but I have two family members who are nurses. Both have admitted to looking at my records (and other peoples’ records) in the past. This has made me incredibly uncomfortable with the idea of seeking help.

Comment on BMJ: A series of unfortunate events by DeeDee Ramona

DeeDee Ramona — Fri, 05 Mar 2010 16:12:48 +0000

I want to apologise for posting such an offensive comment. I was angry about something else at the time and typed without thinking that it looked like I was accusing you of not doing your job properly, which wasn’t the intention at all. Anyway what I should have done was just typing the first 2 sentences of my comment and left it at that.
Once again, I’m sorry.

Comment on Charles Bonnet syndrome by Louise Pembroke

Louise Pembroke — Thu, 04 Mar 2010 21:26:39 +0000

This is interesting because my eye condition [not CBS] in part caused me to go mad in my youth and I’m just learning that some of my visual perceptual differences might be attributed to my eyes and not my voices. This raises many questions for me regarding the sight/mental health interface which can be left by the way side in psychiatry. Even when it was noticed I was reading 2″ away from my face that didn’t seem worthy of any discussion. There have been some AJP papers tring to link Keratoconus with Schizophrenia or to define a ‘Keratotonic personality’ but I reckon us folk with wonky eyes might be more inclined to lose the plot simply because it’s distressing to not be able to see well or have visual distortions.

Comment on Charles Bonnet syndrome by acountrydoctorwrites

acountrydoctorwrites — Tue, 02 Mar 2010 02:37:59 +0000

Just saw your post on CBS. I once had a patient with this fascinating condition and blogged about him:
http://acountrydoctorwrites.wordpress.com/2008/09/24/visions-of-little-people/

ACDW

Comment on Urban living, migration and mental health by Bee

Bee — Mon, 01 Mar 2010 16:54:46 +0000

This is really interesting for me as a new urban planner with a strong interest in mental illness and psychology….
I can’t pretend to know that much about either at the moment though!

But perhaps the correlation between the two might in part be due to the dazzle of disorder. The mind cannot rest in one place if control levels are low, but must dance erratically from one thought, vision etc to another. It could be seen as a survival necessity.
In a higher and more disordered population the possible threat to a person is less controlled and more imediate and could come from a higher number of sources. In a modern urban environment we are constantly bombarded by information which we barely have time to register or reason through before we must move on.
It makes sense therefore that there will be higher incidences of mental illness and less sense of permanance or reality.