How doctors think

Before I went to med school, I went to see my GP with a minor skin problem on my chest.  I walked in ready to show them the problem.  I was baffled when they wanted to talk first.  Surely looking was the important bit…It was only some years later that I understood the reasoning. 

A medical assessment, or clerking in UK medical lingo, is made up of 7 core elements; problem, history of presenting problem, past medical history, allergies, medications, social history.  It’s only after this that we move on to examining.  It’s the listening that allows us to lay the foundations to our thinking.  When starting out as a medical student you tend to stick to it rigidly, a safety blanket in the complex world of unknown conditions & odd sounding medications.  As experience grows the structure may become less obvious, but it’s ever present. 

Why context matters.

Why do we use this framework?  Simply, it is a structured way to gather the context to someone’s current ill health experience, making sure nothing important is missed.   Their medical past influences their current & future – the chance of having future heart problems is greater with previous heart problems.  Other facets of their life, such as their social history – with whom they live, current levels of mobility & so on influence how someone can cope with illness & the impact it has on their life, as well as the support structures to draw from in hard times.

What’s a medical record?

Medical records in their simplest form allow us to capture the contextual information & keep it updated.   They mean we can pick up the conversation already primed with information.  Without a medical record, we rely wholly on recollection.  

Medical records in Covid times

When we started delivering Covid jabs in the UK we lacked a platform to capture the delivery of jabs but also there was no access to a medical record out of the GP settings.  This meant that we had to rely wholly on asking patients themselves about medications or allergies that a patient may have suffered decades previously. 

At Eva, we realised that having a vaccination software solution was going to be critical to supporting clinicians in the delivery of the Covid vaccination programme, so eVacc was developed.  To help pump-prime the conversations & allow us as clinicians to cross check important contextual information like allergies & medications, at Eva we’ve built eView.  It’s a natural counterpart to eVacc. 

How eView works in practice

Clinicians are provided with login details to eView & after confirming with the patient (or their proxy) that they consent to you accessing this information, you are given view only rights to the core parts of the GP medical record.  This includes – medical problems, allergies, medications & recent consultations.  This is just the information needed to be able to support safe decision-making when delivering Covid jabs (i.e. direct patient care).  It can be accessed without patient consent only in emergencies e.g. an unconscious patient in the waiting room for whom checking their allergies or finding out they are diabetic could be life saving.  

Safe & assured

With approved access to the NHS Patient Demographic Service, you can identify your patient and find their registered GP practice, and then with NHS GP Connect view-only record access you can see your patient’s latest information for your patient.  To ensure access is always legitimate, users have to document the reason for access too (i.e. direct patient care with consent or emergency access).  eView is view only, available over the internet in a normal browser without a download – so there are no copies of data stored locally and no concerns about the security of downloads.

How to get your hands on it…

It’s available as a free upgrade for existing eVacc customers. 

This is part of Eva’s mission to put better tech in the hands of NHS clinicians, and the next step in our journey to a medical record platform fit for the future of healthcare.

Find out more here: