SystmOnline
It is a contractual requirement to offer online record access to patients. As a practice you should decide how you wish to provide this and put in place a rigid sign up process. Consideration should be made for vulnerable patients, patients with sensitive coded entries or coded entries that may cause distress or alarm. A process may need to be put in place to check the records before giving access to the patient.
The RCGP has released a comprehensive toolkit to help practices implement online services safely.
Patients can have either Detailed Coded Record Access or Full Clinical Record Access:
Detailed Coded Record Access
- All read codes
- Allergies/adverse reactions
- Demographics
- Immunisations
- Medications
- Problems / diagnoses
- Test Results (numeric values and normal range)
- Consent to share settings
- Patients cannot see free text, letters or attachments
- Patients cannot see any entries marked as 'Do not show in Online Record'
Full Clinical Record Access
- Everything in detailed coded record
- Free text (including text added to codes, results and consultations)
- Letters and attachments
- Patients cannot see any entries marked as 'Do not show in Online Record'
Patients also cannot see any SMS messages sent from SystmOne to the patient and cannot see any messages they have sent on SystmOnline (e.g. medication requests). There may also be a date restriction set by the practice so nothing before this date will be seen either.
How to enable online record access
Go to >Set up >Users & Policies >Organisation Preferences. Scroll down the left to Online Services and select Patient Record Access. You should then see something similar to this below.
- All patients who have signed up to SystmOnline should have access to their Summary Care Record.
- If a patient has requested access to the detailed coded record, as a practice, you can decide on the date options.
- You may not wish to allow patients access to the record audits, but by giving them access they can see when another organisation has access their record so can be quite useful.
- And the last option (sharing Information) is a fairly new one to allow patients to view their consent to share (in and out) settings.
There is a way to see exactly what the patient can see once they have either detailed coded record or full record access. If you retrieve the patient record and go to the New Journal you can select either of the pre-set filters as displayed below.
Please note:
These filters do not appear if you are using the Tabbed Journal, you will need to have access to the New Journal. If this isn't in your clinical tree, instruction on how to add this can be found here. TPP has confirmed that there is no way to setup these filters on the Tabbed Journal.
(A Development Request has been submitted to TPP requesting the filters be made available on the tabbed journal - ref number a1520000)
Please be aware - the 'Online Full Clinical Record' filter is not currently displaying free text comments added to read codes either from the read code browser or from coded entries from a template. If the patient has full clinical record access these are visible to the patient. This has been reported to TPP reference number 789735.
This is an example screenshot of the online detailed coded record filter. Patients can see medications, read coded entries, pathology requests, vaccinations and recalls. Any freetext is not visible, even if it has been added as a comment to a read coded entry. However, pathology result filing comments can be seen.
If a clinician is concerned when adding an entry in the patient record, then there is an option to change the Privacy Settings so that it isn't visible in SystmOnline. found out more about Privacy Settings here:
This is a screen shot of how the record is displayed in SystmOnline.
Patients can now see what 'Sharing In' and 'Sharing Out' preferences have been set on their record. The 'Status' text is very confusing for patients though. The TPP help desk has been approached to amend this text to a more easily understandable format - TPP reference number 724691
Mobile App
From the App home page click on 'More'
Then you can click on 'Record'