JMIR Publications

ABSTRACT

Background:

From 1st November 2022, patients accessing their care from NHS England will have full online access to new data added to their general practitioner (GP) record, by default. Since April 2019, the GP contract in England already commits practices to offering patients full online record access, on a prospective basis and on request. However, there has been limited research into GPs’ experiences and opinions about this practice innovation.

Objective:

To explore the experiences and opinions of GPs in England about patients’ access to their full online health record, including the clinicians’ free text summaries of the consultation (so-called ‘open notes’).

Methods:

In March 2022, a web-based survey of 400 UK GPs’ to explore their experiences and opinions about the impact to patients, and GPs’ practices, of offering patients full online access to their health records. Qualitative descriptive analysis of written responses (‘comments’) to four open-ended questions embedded in an online questionnaire.

Results:

Comments were classified into four major themes: (i) increased strain on GP practices; (ii) the potential to harm patients; (iii) changes to documentation; and (iv) legal concerns. GPs believed patient access would lead to extra work for GPs, reduced efficiencies, and increased burnout. Participants also believed access would increase patient anxieties and incur risks to patient safety. Experienced and perceived documentation changes included reduced candor, and changes to record functionality. Anticipated legal concerns encompassed fears about increased litigation risks, and lack of legal guidance to GPs about how to manage documentation that would be read by patients, and potential third parties.

Conclusions:

This study presents timely information on GPs’ views about patient access to their online health records. Overwhelmingly, GPs were skeptical about the benefits of access both for patients, and to their practices. These views are similar to those expressed by clinicians in other countries, including the Nordic countries and the U.S., prior to patient access. More extensive, qualitative research is required to understand the perspectives of patients in England after experience with accessing their online records. Finally, further research is needed to explore objective measures of impact of patient access to their records on health outcomes, clinician workload, and changes to documentation.