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

Rosa Rlc Thielmann, Ciska Hoving, Esther Schutgens-Kok, Jochen Wl Cals, Rik Crutzen
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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:关于患者需求和期望的定性研究。
背景:患者在线查阅病历被认为能增强患者的能力,促进以患者为中心的医疗保健。自 2020 年 7 月起,荷兰的患者在法律上有权在全科诊所以电子方式查阅自己的病历。先行国家的经验表明,尽管患者兴趣浓厚,但用户使用率往往很低。如何为实施提供最佳支持取决于患者的个人需求和期望,而荷兰的情况尚不清楚:目的:了解荷兰患者对全科医生在线访问病历的需求和期望:方法:20 名参与者通过视频或电话完成了半结构化个人访谈。使用 Atlas.ti 软件对访谈记录进行模板分析,结合演绎和归纳编码:患者的需求和期望涉及三个重叠领域:(i) 获得在线访问权限的前提条件;(ii) 使用在线访问权限;(iii) 对与医疗服务提供者互动的影响。患者期望从在线访问中获益,如更好地了解概况、增强能力和改善与全科医生的沟通,但也指出了在技术难度、数据隐私和病历中复杂的医疗语言方面的需求:结论:参与者指出的问题和障碍表明,全科医生需要进行组织变革,例如调整记录方法,全科医生和员工在推动和促进在线访问方面发挥着关键作用:影响:针对本研究中发现的需求而制定的实施策略可能有助于释放在线访问的全部潜力,从而实现患者参与和满意度的预期结果。
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