What are the views and experiences of primary care staff regarding patients having online access to their electronic primary care health record?
Problem
At the time of writing, NHS England state that from April 2022, all adult patients who have an account with an online records access (ORA) service such as the NHS App, will be able to view new entries in their record, including free text, letters, and documents. Despite this, little is known about the views and experiences of primary care staff on this topic. This study aims to find out more about what primary care staff think and feel about ORA, and what support they may need to help with this transition.
Approach
We are conducting fifty semi-structured interviews with clinical and non-clinical primary care staff, from a mix of urban/rural and affluent/less affluent practices. We have conducted a preliminary analysis of the first 20 interviews, and will conduct a thematic analysis on the full dataset when available.
Findings
A preliminary analysis categorised views expressed regarding ORA according to the Institute of Medicine’s 6 domains of healthcare quality: 1) Patient centeredness (e.g. the potential to increase patients autonomy or cause patients distress), 2) Effectiveness (e.g. impacting upon the consideration of potential differential diagnoses), 3) Safety (e.g. access by an abusive partner), 4) Efficiency (e.g. the potential for both positive and negative impacts on workload), 5) Timeliness (e.g. reducing delays for patients or delaying other aspects of care), and 6) Equity (e.g. disproportionately benefiting the ‘worried well’).
Consequences
Although primary care staff report benefits of ORA, they also have a number of significant concerns. Future work could explore how primary care staff could be further supported to use ORA to empower and activate patients to be equal partners in managing their healthcare. ORA will require that healthcare practitioners adapt the manner in which they consult and write in the medical record. Future work needs to examine how we can maximise the benefits and minimise the risks involved.