Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands.
Eindhoven University of Technology, Eindhoven, Netherlands.
J Med Internet Res. 2021 Aug 27;23(8):e28045. doi: 10.2196/28045.
Patients in a range of health care sectors can access their medical health records using a patient portal. In mental health care, the use of patient portals among mental health care professionals remains low. Mental health care professionals are concerned that patient access to electronic health records (EHRs) will negatively affect the patient's well-being and privacy as well as the professional's own workload.
This study aims to provide insights into the appraisal work of mental health care professionals to assess and understand patient access to their EHRs through a patient portal.
We conducted a qualitative study that included 10 semistructured interviews (n=11) and a focus group (n=10). Participants in both the interviews and the focus group were mental health care professionals from different professional backgrounds and staff employees (eg, team leaders and communication advisors). We collected data on their opinions and experiences with the recently implemented patient portal and their attempts to modify work practices.
Our study provides insights into mental health care professionals' appraisal work to assess and understand patient access to the EHR through a patient portal. A total of four topics emerged from our data analysis: appraising the effect on the patient-professional relationship, appraising the challenge of sharing and registering delicate information, appraising patient vulnerability, and redefining consultation routines and registration practices.
Mental health care professionals struggle with the effects of web-based patient access and are searching for the best ways to modify their registration and consultation practices. Our participants seem to appraise the effects of web-based patient access individually. Our study signals the lack of systematization and communal appraisal. It also suggests various solutions to the challenges faced by mental health care professionals. To optimize the effects of web-based patient access to EHRs, mental health care professionals need to be involved in the process of developing, implementing, and embedding patient portals.
在多个医疗保健领域，患者可以使用患者门户访问他们的医疗健康记录。在精神卫生保健中，精神卫生保健专业人员对患者门户的使用仍然较低。精神卫生保健专业人员担心，患者访问电子健康记录 (EHR) 将对患者的福祉和隐私以及专业人员自身的工作量产生负面影响。
本研究旨在深入了解精神卫生保健专业人员的评估工作，以通过患者门户评估和理解患者对其 EHR 的访问。
我们进行了一项定性研究，包括 10 次半结构化访谈（n=11）和一次焦点小组（n=10）。访谈和焦点小组的参与者均来自不同专业背景和员工（如团队领导和沟通顾问）的精神卫生保健专业人员。我们收集了他们对最近实施的患者门户的意见和经验以及他们尝试修改工作实践的意见。
我们的研究深入了解了精神卫生保健专业人员的评估工作，以通过患者门户评估和理解患者对 EHR 的访问。我们从数据分析中得出了四个主题：评估对医患关系的影响，评估共享和记录敏感信息的挑战，评估患者的脆弱性，以及重新定义咨询常规和登记实践。
精神卫生保健专业人员正在努力应对基于网络的患者访问的影响，并正在寻找修改其登记和咨询实践的最佳方法。我们的参与者似乎单独评估基于网络的患者访问的影响。我们的研究表明缺乏系统化和共同评估。它还提出了精神卫生保健专业人员面临的各种挑战的解决方案。为了优化基于网络的患者对 EHR 的访问效果，精神卫生保健专业人员需要参与开发、实施和嵌入患者门户的过程。
