基层医疗服务人员对患者在线访问其电子健康记录的看法和经验:一项定性研究
Primary care staff's views and experience of patients' online access to their electronic health record: a qualitative exploration.
机构信息
Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK.
Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, US.
出版信息
Br J Gen Pract. 2023 May 25;73(731):e418-e426. doi: 10.3399/BJGP.2022.0436. Print 2023 Jun.
BACKGROUND
NHS England have announced plans to enable all adult patients to have full prospective access to their primary care record by default. Despite this, little is known about the views and experiences of primary care staff regarding patients' online records access (ORA).
AIM
To examine the views and experiences of primary care staff regarding patients having online access to their primary care health record, and how this service could be supported and improved.
DESIGN AND SETTING
A qualitative study of a purposive sample of 30 primary care staff in England.
METHOD
Online semi-structured interviews with primary care staff were conducted between December 2021 and March 2022. Verbatim transcripts were analysed inductively using thematic analysis.
RESULTS
Most staff agreed with the principle of patient access to online health records but had mixed feelings regarding the potential benefits and drawbacks of applying this in practice. Staff identified opportunities for improving patient engagement, health literacy, and efficiencies in some administrative workloads, as well as concerns about maintaining the clinical integrity of patient records and ensuring that staff and patient safety and wellbeing are protected.
CONCLUSION
Participants acknowledged that ORA may transform the purpose and function of the record and that ORA has potential to instigate a significant cultural shift in primary care, changing how staff work and relate to patients. This underlines the need for additional staff training and support to expand capability and capacity to adapt practice and enhance patient engagement with, and understanding of, their health records.
背景
英格兰国民保健署 (NHS England) 宣布计划使所有成年患者默认能够全面、前瞻性地访问其初级保健记录。尽管如此,人们对初级保健工作人员对患者在线记录访问 (ORA) 的看法和经验知之甚少。
目的
探讨初级保健工作人员对患者在线访问其初级保健健康记录的看法和经验,以及如何支持和改进这项服务。
设计和设置
对英格兰的 30 名初级保健工作人员进行了一项有目的抽样的定性研究。
方法
在 2021 年 12 月至 2022 年 3 月期间,对初级保健工作人员进行了在线半结构式访谈。使用主题分析对逐字记录进行了归纳式分析。
结果
大多数工作人员原则上同意患者在线访问健康记录的权利,但对在实践中应用这一权利的潜在好处和弊端持不同看法。工作人员认为,在改善患者参与度、健康素养和某些行政工作效率方面有机会,同时也对维护患者记录的临床完整性以及确保工作人员和患者的安全和福祉表示担忧。
结论
参与者承认,ORA 可能改变记录的目的和功能,ORA 有可能引发初级保健领域的重大文化转变,改变工作人员的工作方式和与患者的关系。这突显了需要额外的员工培训和支持,以扩大能力,适应实践,并增强患者对其健康记录的参与度和理解。