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OBJECTIVES To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care(More)
Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen were first published by the British Committee for Standards in Haematology (BCSH) in 1996 and formally reviewed in 2002. Although the guidelines originated from discussion within the BCSH, the intended readership is wide given the multidisciplinary(More)
BACKGROUND Improving understanding of the genetic basis of disease susceptibility enables us to estimate individuals' risk of developing cancer and offer them disease prevention, including screening, stratified to reflect that risk. Little attention has so far been given to the implementation of stratified screening. This article reviews the issues that(More)
BACKGROUND Information is lacking on how concerns about child maltreatment are recorded in primary care records. AIM To determine how the recording of child maltreatment concerns can be improved. DESIGN AND SETTING Development of a quality improvement intervention involving: clinical audit, a descriptive survey, telephone interviews, a workshop,(More)
Strict control of systolic blood pressure is known to slow progression of chronic kidney disease (CKD). Here we compared audit-based education (ABE) to guidelines and prompts or usual practice in lowering systolic blood pressure in people with CKD. This 2-year cluster randomized trial included 93 volunteer general practices randomized into three arms with(More)
The publication of More Genes Direct by the Human Genetics Commission is a timely reminder of the potential impact that 'over-the-counter' genetic testing (that is, a direct genetic test without the need for a medical referral) may have on the NHS. This article considers the relevance of current genetic research on complex common diseases and how this might(More)
Genetic services are receiving increasing numbers of referrals of people with a family history of cancer for assessment of genetic risk, and therefore need to find cost-effective ways of meeting this rising demand. General Practitioners (GPs) are known to be reluctant to take on genetic consultations. Current evidence suggests that black and ethnic(More)
Many people use online applications to communicate with friends, book travel and hotels, order goods, organise diaries and conduct their affairs. It is therefore reasonable that patients may expect to interact with their general practice online. Internationally online access is provided by some general medical services providers 1 and in certain specialist(More)