How do we set the records straight?

In the United Kingdom there are plans to make elements of patients' electronic health records available to any practitioner with “a legitimate care relationship” anywhere in the country. There is justifiable unease about confidentiality and consent in this new environment. Will patients understand what is happening to information about them, and will that information be secure?

Another cause for concern, which is perhaps even more fundamental, has to do with how a medical record's context contributes to its meaning.

Half of general practices in the United Kingdom are now minimising their use of paper, with routine record keeping being done on computer rather than on the traditional record card. While appreciating the greater accessibility of information in a computerised record, many GPs still miss the feeling that, just by holding a records envelope in their hand, all sorts of knowledge will seep into their brains. Thickness, weight, state of repair, handwriting, and wee diagrams all contribute. Why can't electronic records carry more of this context?

What GPs think of as useful …