Skip to main content

Patients online access to their electronic health records and linked online services

Online access to medical records by patients has the potential to promote patient-centred care and improve patient satisfaction.  Online services may also offer patients greater convenience although concerns remain about privacy and confidentiality. However, online access and services may also prove to be an additional burden for healthcare providers who are already under considerable workload pressures.

In a study published in the British Journal General Practice, I and colleagues form other UK universities assessed the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. We carried out a systematic review that focused on all studies about online record access and transactional services in primary care.

We identified 176 studies, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were often patient-led; for example, through identifying medication errors and facilitating increased use of preventive services.

Provision of online record access and services resulted in a moderate increase of e-mail contact but no change on telephone contact. There were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. In general online access to EHRs and online services was generally positive in its impact on areas such as patient satisfaction and patient safety.

The findings from this review are important for health systems and professionals. Although online access may be achievable, there remain challenges about clinicians’ adoption of systems because of workload and workflow concerns. The business model for primary care may also need to change to enable more effective utilisation of information technology in everyday practice.

Comments

Post a Comment

Popular posts from this blog

What is the difference between primordial prevention and primary prevention?

Primordial prevention and primary prevention are both crucial strategies for promoting health, but they operate at different levels. Primordial prevention aims to address the root causes of health problems and improve the wider determinants of health. It focuses on preventing the emergence of risk factors in the first place by tackling the underlying social, economic, and environmental determinants of health. This involves broad, population-wide interventions such as: Policies that promote healthy food choices: Think about initiatives like taxing sugary drinks to discourage unhealthy consumption, or providing subsidies for fruits and vegetables to make them more accessible. Urban planning that prioritises well-being: This could include creating walkable neighborhoods with safe cycling routes, ensuring access to green spaces for recreation and relaxation, and designing communities that foster social connections. Social programs that address inequality: Initiatives aimed at reducing pov...
Post a Comment
Read more

UK Covid-19 Inquiry - The Importance of a Strong Primary Healthcare System

In my witness statement for Module 10 of the UK Covid-19 Inquiry, I discuss the pandemic's impact through from the perspectives of  primary care and public health, drawing on my extensive experience as a senior academic at Imperial College London and as a practising GP and NHS Public Health Specialist.  I emphasise that the pandemic disproportionately affected people who were clinically vulnerable, the disabled, ethnic minority communities and those living in deprived areas. The pandemic highlighted how structural inequalities, multigenerational housing, and employment in high-risk frontline roles exacerbated health disparities.  My statement also critiques the weakening of public health infrastructure - particularly for the control of infectious diseases - and the lack of integrated health data systems to identify at-risk groups such as the clinically vulnerable. I also advocated for a more robust preventive healthcare model that prioritises community-based primary care ...
Post a Comment
Read more

Relevance Over Recall: Rethinking How AI Uses Clinical Data

Our article in the Journal of the Royal Society of Medicine argues that safe and effective AI in healthcare must incorporate mechanisms that emulate human judgement - down-weighting old, inaccurate or superseded information and prioritising what is recent, clinically relevant and reaffirmed - so that AI supports, rather than disrupts, high-quality patient care.  Clinicians constantly revise, reinterpret and filter past information so that only what is relevant, accurate and timely shapes present-day management decisions; medical records function as dynamic “working tools” rather than fixed archives. By contrast, many AI systems lack this capacity for selective forgetting and often treat all historical data as equally meaningful.  This can lead to outdated or low-confidence diagnoses being repeatedly resurfaced, persistent labels influencing clinical expectations, and irrelevant, long-resolved events cluttering summaries and decision-support outputs. Such indiscriminate recall...
Post a Comment
Read more