4.2 Article

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

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SAGE PUBLICATIONS INC
DOI: 10.1177/18333583221144666

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electronic health records; health records; personal; medical records; patient access to records; patient portals; patient participation; qualitative research; health information management

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Dutch patients have needs and expectations for online access to their medical records, including better overview, empowerment, and improved communication. However, technological difficulties, data privacy, and the complexity of medical records present obstacles during implementation.
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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