By 2013, England will have a commissioning process which rewards health professionals who use the government's newly-published Information Strategy for Health and Social Care to put people in greater control of their health, and penalises those who do not, a leading expert has forecast.

The Strategy, which has been "long in the making," is long on rhetoric and not so much on implementation, and to an extent this is deliberate, Charles Gutteridge, National Clinical Director for Informatics at the Department of Health, told a Westminster Health Forum meeting in London recently.

Evidence shows that putting rewards and penalties in place does make a difference to the adoption of new systems, said Dr Gutteridge. He called on health professionals to send the Department ideas for implementation of the Strategy, with particular reference to the dates set out in the document, and stressed the importance of keeping it local.

This is about creating demand in patients. "You have to change the way you do things - and, as you do, patients start to get it," he told doctors. Health is about knowledge and is related to income - it is no longer a science question, and the problems of unhealthy behaviours will not be solved smarter science, he said. 

The value of online information tools for patients are already becoming clear, Dr Gutteridge told the meeting. For example, the Renal PatientView site is very successful; it addresses renal patients' very specific needs, and the 20% of patients who use it intensely are changing their own care - the data shows that they are already doing "a little better" than those who never or rarely visit the site, he said. 

The government's goal for every person to be able to see their GP record online by 2015 presents a fantastic opportunity for getting information to patients, added Dr Gutteridge. 

However, other experts, including British Medical Association (BMA) GPs committee chairman Dr Laurence Buckman, have warned of the challenges involved.

"We believe patients should have access to their health records but we'd want to be satisfied that their records would remain secure before this was implemented," said Dr Buckman, adding: "we would need to see the detail on the 'clinical portals,’ as while we support the sharing of relevant information between healthcare professionals, there are challenges with shared electronic systems."

King's Fund analyst Dr Veena Raleigh also points out that, at a time of unprecedented financial constraint, some commissioners and providers will find it challenging to invest in developing information systems rather than frontline services.

"We need to be realistic about what is achievable in the short to medium term," she says.

Nevertheless, Dr Raleigh also notes that while there are huge benefits to be gained from putting information in the hands of patients, this has often encountered professional resistance in the past. "Data governance issues should not be used as an excuse for inaction - the default position should be for data to be accessible to patients unless there are clear reasons not to make it available," she says.