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Patient Online Record Access in English Primary Care: Qualitative Survey Study of General Practitioners’ Views
Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, US; Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, US. (Participatory e-health and health data)
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2023 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25, article id e43496Article in journal (Refereed) Published
Abstract [en]

Background: In 2022, NHS England announced plans to ensure that all adult primary care patients in England would have full online access to new data added to their general practitioner (GP) record. However, this plan has not yet been fully implemented. Since April 2020, the GP contract in England has already committed to offering patients full online record access on a prospective basis and on request. However, there has been limited research into UK GPs’ experiences and opinions about this practice innovation. Objective: This study aimed to explore the experiences and opinions of GPs in England about patients’ access to their full web-based health record, including clinicians’ free-text summaries of the consultation (so-called “open notes”). Methods: In March 2022, using a convenience sample, we administered a web-based mixed methods survey of 400 GPs in the United Kingdom to explore their experiences and opinions about the impact on patients and GPs’ practices to offer patients full online access to their health records. Participants were recruited using the clinician marketing service Doctors.net.uk from registered GPs currently working in England. We conducted a qualitative descriptive analysis of written responses (“comments”) to 4 open-ended questions embedded in a web-based questionnaire. Results: Of 400 GPs, 224 (56%) left comments that were classified into 4 major themes: increased strain on GP practices, the potential to harm patients, changes to documentation, and legal concerns. GPs believed that patient access would lead to extra work for them, reduced efficiency, and increased burnout. The participants also believed that access would increase patient anxiety and incur risks to patient safety. Experienced and perceived documentation changes included reduced candor and changes to record functionality. Anticipated legal concerns encompassed fears about increased litigation risks and lack of legal guidance to GPs about how to manage documentation that would be read by patients and potential third parties. Conclusions: This study provides timely information on the views of GPs in England regarding patient access to their web-based health records. Overwhelmingly, GPs were skeptical about the benefits of access both for patients and to their practices. These views are similar to those expressed by clinicians in other countries, including Nordic countries and the United States before patient access. The survey was limited by the convenience sample, and it is not possible to infer that our sample was representative of the opinions of GPs in England. More extensive, qualitative research is required to understand the perspectives of patients in England after experiencing access to their web-based records. Finally, further research is needed to explore objective measures of the impact of patient access to their records on health outcomes, clinician workload, and changes to documentation.

Place, publisher, year, edition, pages
JMIR Publications, 2023. Vol. 25, article id e43496
Keywords [en]
electronic health records, attitudes, general practice, patients, online record access, open notes, opinions, primary care, qualitative research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Medical Informatics
Identifiers
URN: urn:nbn:se:uu:diva-497032DOI: 10.2196/43496ISI: 001009104800001PubMedID: 36811939OAI: oai:DiVA.org:uu-497032DiVA, id: diva2:1738827
Note

De två sista författarna delar sistaförfattarskapet

Available from: 2023-02-23 Created: 2023-02-23 Last updated: 2024-01-17Bibliographically approved

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Blease, CharlotteKharko, AnnaHägglund, Maria

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CiteExportLink to record
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