Online access to medical records: finding ways to minimise harms

Woodman, Jenny; Sohal, Alex Hardip; Gilbert, Ruth; Feder, Gene

doi:10.3399/bjgp15x685129

Cited by 18 publications

(16 citation statements)

References 6 publications

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“…This should be supported by mandatory training covering how to respond to the female,5 children,34 and male35 victims. This is even more urgent given the move to online EPRs with patient access 22. This has wider implications for documenting sensitive information in general.…”

Section: Discussionmentioning

confidence: 99%

Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children

Drinkwater¹,

Stanley

Szilassy

et al. 2017

Br J Gen Pract

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BackgroundDomestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family.AimTo explore how and why general practice clinicians document DVA in families with children.Design and settingA qualitative interview study using vignettes with GPs and practice nurses (PNs) in England.MethodSemi-structured telephone interviews with 54 clinicians (42 GPs and 12 PNs) were conducted across six sites in England. Data were analysed thematically using a coding frame incorporating concepts from the literature and emerging themes.ResultsMost clinicians recognised DVA and its impact on child safeguarding, but struggled to work out the best way to document it. They described tensions among the different roles of the EPR: a legal document; providing continuity of care; information sharing to improve safety; and a patient-owned record. This led to strategies to hide information, so that it was only available to other clinicians.ConclusionManaging DVA in families with children is complex and challenging for general practice clinicians. National integrated guidance is urgently needed regarding how clinicians should manage the competing roles of the EPR, while maintaining safety of the whole family, especially in the context of online EPRs and patient access.

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Section: Discussionmentioning

confidence: 99%

Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children

Drinkwater¹,

Stanley

Szilassy

et al. 2017

Br J Gen Pract

Self Cite

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“…Despite the complexity of the problem (de Lusignan et al, 2014;Mold et al, 2012Mold et al, , 2015Tieu et al, 2016;Woodman et al, 2015), there are efforts underway to enable each adult to have full access to their own medical records (Hankewitz, 2016;Kelsey & Cavendish, 2014;Suberg, 2017).…”

Section: Introductionmentioning

confidence: 99%

Hitching Healthcare to the Chain: An Introduction to Blockchain Technology in the Healthcare Sector

Engelhardt¹

2017

TIM Review

308

186

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“…This tension may be further complicated by the trend towards patient online access to their own health records (Woodman et al . ). Some clinicians interviewed were concerned about the potential for coercive partners to gain access to any records that they might document.…”

Section: Resultsmentioning

confidence: 97%

Making the links between domestic violence and child safeguarding: an evidence-based pilot training for general practice

Szilassy

Drinkwater

Hester

et al. 2016

Health Soc Care Community

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We describe the development of an evidence‐based training intervention on domestic violence and child safeguarding for general practice teams. We aimed – in the context of a pilot study – to improve knowledge, skills, attitudes and self‐efficacy of general practice clinicians caring for families affected by domestic violence. Our evidence sources included: a systematic review of training interventions aiming to improve professional responses to children affected by domestic violence; content mapping of relevant current training in England; qualitative assessment of general practice professionals' responses to domestic violence in families; and a two‐stage consensus process with a multi‐professional stakeholder group. Data were collected between January and December 2013. This paper reports key research findings and their implications for practice and policy; describes how the research findings informed the training development and outlines the principal features of the training intervention. We found lack of cohesion and co‐ordination in the approach to domestic violence and child safeguarding. General practice clinicians have insufficient understanding of multi‐agency work, a limited competence in gauging thresholds for child protection referral to children's services and little understanding of outcomes for children. While prioritising children's safety, they are more inclined to engage directly with abusive parents than with affected children. Our research reveals uncertainty and confusion surrounding the recording of domestic violence cases in families' medical records. These findings informed the design of the RESPONDS training, which was developed in 2014 to encourage general practice clinicians to overcome barriers and engage more extensively with adults experiencing abuse, as well as responding directly to the needs of children. We conclude that general practice clinicians need more support in managing the complexity of this area of practice. We need to integrate and further evaluate responses to the needs of children exposed to domestic violence into general practice‐based domestic violence training.

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Online access to medical records: finding ways to minimise harms

Cited by 18 publications

References 6 publications

Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children

Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children

Hitching Healthcare to the Chain: An Introduction to Blockchain Technology in the Healthcare Sector

Making the links between domestic violence and child safeguarding: an evidence-based pilot training for general practice

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