精神卫生保健患者获取电子健康记录的体验：来自爱沙尼亚、芬兰、挪威和瑞典的跨国调查结果。

Experiences from patients in mental healthcare accessing their electronic health records: results from a cross-national survey in Estonia, Finland, Norway, and Sweden.

机构信息

Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.

Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

出版信息

BMC Psychiatry. 2024 Jul 2;24(1):481. doi: 10.1186/s12888-024-05916-8.

DOI:10.1186/s12888-024-05916-8

PMID:38956493

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11220963/

Abstract

BACKGROUND

Patients' online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users' overall experiences with national PAEHR services.

METHODS

The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users' experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data.

RESULTS

6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information.

CONCLUSIONS

Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.

摘要

背景

患者在线记录访问（ORA）使患者能够通过在线数字解决方案阅读和使用其健康数据。电子健康记录（PAEHR）是这样的解决方案之一，已在爱沙尼亚、芬兰、挪威和瑞典实施。虽然积累的研究指出了 ORA 的许多潜在好处，但它在精神保健（MHC）中的应用仍存在争议。本研究旨在描述 MHC 用户对国家 PAEHR 服务的整体体验。

方法

该研究分析了 NORDeHEALTH 2022 年患者调查的 MHC 部分，这是一项大型多国调查。该调查包含 45 个问题，包括人口统计学变量和与用户 ORA 体验相关的问题。我们专注于与积极体验（好处）、负面体验（错误、遗漏、冒犯）和安全与隐私违规相关的问题。如果他们在过去两年内接受过精神保健，则将参与者纳入本分析。使用描述性统计数据总结数据，并计算可用数据的百分比。

结果

共有 6157 名受访者。与之前的研究一致，近一半（45%）报告对 ORA 有非常积极的体验。每个国家的大多数人还报告说，与医疗保健提供者的信任（至少 69%）和沟通（至少 71%）得到了改善。三分之一（29.5%）报告对 ORA 有非常负面的体验。总的来说，一半的受访者（47.9%）在他们的医疗记录中发现错误，三分之一（35.5%）发现遗漏。三分之一（34.8%）的受访者还报告说他们对内容感到冒犯。当发现错误或遗漏时，约一半（46.5%）的人没有采取任何行动。似乎国家之间的患者对错误、遗漏和缺失信息的体验存在差异。一小部分人报告说，家人或其他人要求访问他们的记录（3.1%），大约十分之一（10.7%）的人注意到未经授权的个人已经看到了他们的健康信息。