By Emma Wilkinson
Health reporter, BBC News
The first patients' electronic records have been uploaded to the new NHS online database.
The e-records programme has been criticised for its slow progress
Around 20 GP surgeries in Bolton and Bury have added 110,000 patients' details to the system, part of the £12bn NHS IT upgrade project.
The e-records will eventually be available to NHS staff nationwide and contain details on medical conditions, current medication and allergies.
In September, MPs criticised the slow progress of the e-records project.
The health committee also raised concerns about security of the database.
But they said the system, which will ultimately contain 50 million medical records, had a huge potential to improve patient care.
The records are due to "go live" in January.
A national roll-out is planned from late 2008, once an evaluation of the pilot sites is completed.
So far more than 550,000 patients in Bolton, Bury, Dorset, south Birmingham and Bradford and Airedale have been asked to register with the scheme.
As well as opting out altogether, patients can choose to only allow access once staff have their explicit consent.
Patients can also view their own records online through the HealthSpace website.
But not all GPs are convinced by the scheme - a recent survey in Bolton found 67 out of the 98 responders were against the idea of e-records.
The current system, which is predominantly paper-based, can lead to unnecessary delays and risks, say proponents of the project.
Marlene Winfield, national patient lead for the programme, said: "Patients are always surprised that their records aren't already available in other parts of the NHS - they say we thought the NHS has been doing this for years."
She admitted it would be a big cultural change but stressed the system would be a lot more secure than current records.
"Patients have to go through a security process before they can set up the record.
"The NHS has always had a confidentiality culture as patient information is regarded by everyone as sensitive - it's in everyone's training and contracts."
OPTIONS FOR E-RECORD ACCESS
Green - record available to any legitimate NHS user and to the patient through HealthSpace
Amber - record only available if patient gives the clinician permission at the time of the consultation and the patient can view it on HealthSpace
Red - there is no record available on the system or on HealthSpace
Dr Richard Vautrey, deputy chair of the British Medical Association GP committee, said there were several questions that needed to be answered by the pilots.
"We want to know patients have been fully informed about the implications.
"The opt-out levels have been very low but we want to make sure that is because patients are happy rather than because of any bureaucracy."
He added that there were reasonable levels of security in accessing the system but recent data leaks from several government departments were causes for concern.
"It shows even in a very secure system, the weakest link is the people using it."
But he said: "The key thing is what patients think about it."
Joyce Robins from Patient Concern also raised the issue of security.
"Our main problem is that they are doing it on an opt-out basis - we think they should ask for consent before records go up."