Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 28, 2023
Open Peer Review Period: Mar 28, 2023 - May 23, 2023
Date Accepted: May 17, 2023
(closed for review but you can still tweet)
Effects of Patient Online Access to General Practice Medical Records: A Longitudinal Survey Study on Patients’ Perceptions
ABSTRACT
Background:
Patient online access to medical records is assumed to facilitate patient empowerment and advance patient-centred healthcare. However, to date, the actual effect of online access on patient perceptions regarding these and other outcomes is insufficiently empirically tested.
Objective:
To investigate the effects that patients perceive from online access on patient empowerment, the patient-provider relationship, and informed decision-making.
Methods:
A nationwide two-wave longitudinal survey study among Dutch adults was conducted (N=2402). Linear regression analyses were conducted. In Model 1, perceived effect of online access (use measured at T1) on sixteen outcomes (measured at T2), associated with use of online access to general practice medical records in previous research, was investigated. Model 2 included socio-demographic factors and patient characteristics as confounders.
Results:
Users indicated more strongly than non-users that online access would increase their participation in healthcare, improve the relationship with their general practitioner, and support informed decision-making. These results were robust when adjusted for influence of confounders. Effect sizes were very small (B ranging between -0.39 and 0.28). Higher digital and health literacy were associated with higher ratings of almost all effects.
Conclusions:
Online access has the potential to empower patients and foster patient informed decision-making. Effects in this study were small but might grow over time. Possibly other factors such as attitude of general practitioners towards online access moderate these effects. Results indicate that potential benefits of online access might be(come) unevenly distributed. We advise future exploration of the conditions under which online access can improve healthcare system functioning and efficiency without increasing health inequality.
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