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一项关于患者对在线获取初级保健记录的体验、需求和期望的定性探索。

A qualitative exploration of patients' experiences, needs and expectations regarding online access to their primary care record.

机构信息

Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK

Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK.

出版信息

BMJ Open. 2021 Mar 11;11(3):e044221. doi: 10.1136/bmjopen-2020-044221.

Abstract

OBJECTIVES

Primary care records have traditionally served the needs and demands of clinicians rather than those of the patient. In England, general practices must promote and offer registered patients online access to their primary care record, and research has shown benefits to both patients and clinicians of doing so. Despite this, we know little about patients' needs and expectations regarding online access to their record. This study explored what patients and carers want from online access to their electronic primary care health record, their experiences of using it, how they would like to interact with their record and what support they may need.

DESIGN

Focus groups and semistructured interviews using purposive sampling to achieve a good sociodemographic spread. Interviews were digitally audiorecorded, transcribed and coded using an established thematic approach.

SETTING

Focus groups and interviews were conducted in community settings in the UK.

PARTICIPANTS

Fifty-four individuals who were either eligible for the National Health Service Health Check, living with more than one long-term condition or caring for someone else.

RESULTS

Participants views regarding online access were categorised into four main themes: awareness, capabilities, consequences and inevitability. Participants felt online access should be better promoted, and suggested a number of additional functions, such as better integration with other parts of the healthcare system. It was felt that online access could improve quality of care (eg, through increased transparency) but also have potential negative consequences (eg, by replacing face to face contact). A move towards more online records access was considered inevitable, but participants noted a need for additional support and training in using the online record, especially to ensure that health inequalities are not exacerbated.

CONCLUSIONS

Discussions with patients and carers about their views of accessing online records have provided useful insights into future directions and potential improvements for this service.

摘要

目的

基层医疗记录传统上服务于临床医生的需求和要求,而不是患者的需求。在英国,全科医生必须为注册患者提供在线访问其初级保健记录的服务,并进行相关研究,以证明此举对患者和临床医生都有益处。尽管如此,我们对患者对在线访问其记录的需求和期望知之甚少。本研究探讨了患者和护理人员希望从在线访问其电子初级保健健康记录中获得什么,他们使用记录的经验,他们希望如何与记录互动以及他们可能需要哪些支持。

设计

使用目的性抽样进行焦点小组和半结构化访谈,以实现良好的社会人口统计学分布。访谈采用数字录音、转录和编码,使用既定的主题方法。

设置

焦点小组和访谈在英国的社区环境中进行。

参与者

54 名符合国民健康服务健康检查条件、患有多种慢性疾病或照顾他人的个人。

结果

参与者对在线访问的看法分为四个主要主题:意识、能力、后果和必然性。参与者认为在线访问应该得到更好的推广,并提出了一些附加功能,如更好地与医疗保健系统的其他部分集成。人们认为在线访问可以改善护理质量(例如,通过增加透明度),但也可能产生潜在的负面影响(例如,通过取代面对面的接触)。更多的在线记录访问被认为是不可避免的,但参与者指出,需要额外的支持和培训来使用在线记录,特别是为了确保不会加剧健康不平等。

结论

与患者和护理人员讨论他们对在线记录的看法,为这项服务的未来方向和潜在改进提供了有用的见解。

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Accessing personal medical records online: a means to what ends?在线获取个人医疗记录:目的何在?
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