JMIR Publications

ABSTRACT

Background:

Online access for patients to their medical records is expected to improve patient empowerment by promoting the patient’s role and responsibility in managing their own health and treatments, as well as supporting shared decision making (SDM). As of July 2020, general practices in The Netherlands are legally required to provide their patients electronic access to their medical records upon request. Practices can provide a digital copy of their health record or give their patients online access to their health data through a patient portal or personal health environment. Providing online access is facilitated and stimulated through a national support program called "OPEN".

Objective:

To investigate general practice staff experiences with providing online access, its impact on patient consultations, administrative actions and patient questions, and how it affects standard general practice workflow processes.

Methods:

3,813 general practices in The Netherlands were invited to fill out an online web-survey including questions about their experiences with the provision of online access to medical records, and how it affects general practice workflow, in October 2021. Descriptive data analysis was performed. We compared general practices that had online access before 2020, in 2020 or in 2021 in order to identify trends.

Results:

523 respondents completed the survey (14% response rate). Almost all general practices (93%) indicated that they provide online access. About one-third of the respondents (37%) was mostly positive about provision of online access, whereas 8% was mostly negative. The majority was neutral (42%) and a smaller share (13%) could not (yet) indicate how they experienced online access. Provision of online access impacts general practices’ workload, according to a large share of the respondents: about two-thirds (66%) reported an increase in the number of e-consultations, and a similar percentage (64%) indicated an increase in the number of administrative actions associated with online access. A small share of practices (10% or less) experienced a decrease in the number of patient contacts. Further, the amount of online access experience was associated with how respondents perceived online access and its impact on the patient contacts and the general practice workflow. In general, earlier adoption of online access was associated with a more positive attitude towards online access and more positive experienced effects related to patient contacts and general practice workflow.

Conclusions:

General practices mainly experience the provision of online access as either neutral or mostly positive, despite the increased number of patient contacts and administrative burden that are associated with its adoption. Future research and policy should focus on how these unintended effects can be counteracted.