JMIR Publications

ABSTRACT

Background:

General practices in England have recently introduced a nationwide electronic personal health record (ePHR) system called Patient Online, which allows patients to view parts of their medical records, book appointments, and request prescription refills. Although this system is free of charge, its adoption rates are low. To improve patients’ adoption and the implementation success of the system, it is important to understand the factors affecting their use of the system.

Objective:

The purpose of this study is to explore patients’ perspectives of factors affecting their use of ePHRs in England.

Methods:

A cross-sectional survey was carried out between 21st August 2017 and 26th September 2017. A questionnaire was used in this survey to collect mainly quantitative data through closed-ended questions in addition to qualitative data through an open-ended question. A convenience sample was recruited in 4 general practices in West Yorkshire, England. Given that the quantitative data were analysed in a previous study, here we analysed the qualitative data using thematic analysis.

Results:

Of 800 eligible patients invited to take part in the survey, 624 (78.0%) patients returned a valid questionnaire. Of those returned questionnaires, the open-ended question was answered by 136 (21.8%) participants. Two meta-themes emerged from participants’ responses. The first meta-theme is made up of five themes about why patients do not use Patient Online: concerns about using Patient Online, lack of awareness of Patient Online, challenges regarding internet and computers, perceived characteristics of non-users, and preferring personal contact. The second meta-theme contains one theme about why patient use Patient Online: encouraging features of Patient Online.

Conclusions:

The challenges and concerns that impede the use of Patient Online seem to be of greater importance than the facilitators that encourage its use. There are practical considerations that, if incorporated into the system, are likely to improve adoption rate: Patient Online should be useful, easy-to-use, secure, and easy-to-access; different channels should be used to increase the awareness of the system; and general practices should ease registration with the system and provide manuals, training sessions, and technical support. More research is needed to assess the effect of the new factors found in this study (e.g. lack of trust, difficulty registering with Patient Online) and factors affecting continuing use of the system.