Patient online access to general practice medical records: A qualitative study on patients' needs and expectations.

R. Thielmann, C. Hoving, Esther Schutgens-Kok, J. Cals, R. Crutzen
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引用次数: 2

Abstract

BACKGROUND Patient online access to medical records is assumed to foster patient empowerment and advance patient-centred healthcare. Since July 2020, patients in the Netherlands have been legally entitled to electronically access their medical record in general practice. Experience from pioneering countries has shown that despite high patient interest, user rates often remain low. How to best support implementation depends on individual needs and expectations of patient populations, which are as yet unknown in the Dutch context. OBJECTIVE To understand Dutch patients' needs and expectations with regard to online access to their medical record in general practice. METHOD Twenty participants completed semi-structured individual interviews via video or telephone call. Transcripts of interviews underwent template analysis combining deductive and inductive coding using Atlas.ti software. RESULTS Patients' needs and expectations ranged across three overlapping areas: (i) prerequisites for getting online access; (ii) using online access; and (iii) the impact on interaction with healthcare providers. Patients expected benefits from online access such as better overview, empowerment and improved communication with their general practitioner but identified needs regarding technological difficulties, data privacy and complex medical language in their record. CONCLUSION The concerns and obstacles participants identified point towards the need for organisational changes in general practice, for example, adjusted documentation practices, and the key role of the general practitioner and staff in promoting and facilitating online access. IMPLICATIONS Implementation strategies addressing needs identified in this study may help to unlock the full potential of online access to achieve desired outcomes of patient involvement and satisfaction.
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患者在线访问全科医疗记录:一项关于患者需求和期望的定性研究。
患者在线访问医疗记录被认为是为了促进患者授权和推进以患者为中心的医疗保健。自2020年7月以来,荷兰的患者在法律上有权在一般实践中以电子方式访问他们的医疗记录。来自开拓性国家的经验表明,尽管患者的兴趣很高,但使用率往往仍然很低。如何最好地支持实施取决于患者群体的个人需求和期望,这在荷兰的情况下尚不清楚。目的了解荷兰患者在一般实践中对在线访问其医疗记录的需求和期望。方法20名参与者通过视频或电话完成半结构化的个人访谈。使用Atlas对访谈笔录进行演绎编码和归纳编码相结合的模板分析。ti的软件。结果:患者的需求和期望跨越三个重叠的领域:(i)获得在线访问的先决条件;(ii)使用在线访问;(三)对与医疗保健提供者互动的影响。患者期望从在线访问中获得好处,例如更好的概述、授权和改善与全科医生的沟通,但也确定了在技术困难、数据隐私和病历中复杂的医疗语言方面的需求。参与者确定的问题和障碍指向全科医生组织变革的需要,例如,调整文档实践,以及全科医生和工作人员在促进和促进在线访问方面的关键作用。含义本研究中确定的满足需求的实施策略可能有助于释放在线访问的全部潜力,以实现患者参与和满意度的预期结果。
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