JMIR Publications

ABSTRACT

Background:

Patient-accessible electronic health records are assumed to enhance quality of care, expressed in terms of safety, timeliness, efficiency, effectiveness, equity, and person-centredness. However, research on the impact of PAEHRs on perceived quality of care among parents, children, and adolescents is largely lacking.

Objective:

This study assessed whether and how using a client-accessible interdisciplinary health record contributes to experienced quality of care, from a client’s perspective.

Methods:

A qualitative design with a phenomenological approach was chosen to explore how parents and adolescents perceived the impact of using EPR-Youth on quality of care. In-depth interviews with one to three persons simultaneously were conducted in2021. A total of 13 parents and seven adolescents were included in the study, representing both sexes, different educational levels, different native countries, and all participating municipalities. Within this group, seven parents had not previously been informed about the existence of a client portal. Their expectations of using the client portal, in relation to quality of care, were discussed after a demonstration of the portal.

Results:

Parents and adolescents reported that using EPR-Youth contributed to the perceived quality of care, as they felt better informed and more involved in the care process than before the introduction of EPR-Youth. Moreover, they indicated to have more control over their health data, had faster and simpler access to their health information and found it easier to manage appointments or ask questions at their convenience. Parents from a migratory background, of whom six out of seven had not previously been informed about the client portal, expected that portal access would give them a better understanding of and more control over their care processes. Although portal usability was regarded high, parents expressed concerns about possible inequal access due to lack of information to parents from a migratory background. Furthermore, both parents and adolescents saw room for improvement in broader interdisciplinary use of EPR-Youth and in the quality of reporting.

Conclusions:

Using EPR-Youth can contribute to client-experienced quality of care, more specifically to perceived person-centeredness, timeliness, safety, efficiency, and integration of care. However, some quality aspects, such as equity, still need addressing. In general, client information about the portal needs to be improved, with a specific focus on people in vulnerable circumstances, such as those from migratory backgrounds. Additionally, to maximize the potential benefit of using EPR-Youth, a person-centred attitude among professionals is important. Considering the small number of adolescent participants (n=7), adding quantitative data from a structured survey could strengthen the available evidence.