A comparison of English and French approaches to providing patients access to Summary Care Records: scope, consent, cost.

Online access to records is part of the process of empowering patients. National health services in both France and England have introduced systems to provide online access to summary health data. The English system was called the "Summary Care Record (SCR)," made accessible to patients through "HealthSpace". The French system Dossier Médical Personnel (DMP) is a patient controlled record clinicians enter data into. The objective was to compare the programmes and lessons from the introduction of patient access. We carried out a literature review. The English system has been progressively de-scoped, with HealthSpace due to close in 2013, only 0.01% of the population signing up for "advanced accounts". The French system slowly grows as more documents are added; though only 0.31% of the population have opened a DMP. The English SCR has an opt-out consent model, whereas the French DMP is patient controlled opt-in consent model. The SCR sits within an NHS intranet while the DMP sits on the Internet. Both systems have costs of around 200 million Euro. Providing patients online access to their medical records is potentially empowering. However, the English HealthSpace and SCR have failed to deliver and are due to be withdrawn as methods of providing patients online access. The French system is still in operation but much criticized for its high costs and low uptake. The design of these systems does not appear to have met patients' needs or been readily integrated into physicians workflow.