Perspectives of New Zealand patients and GPs at the beginning of patient portal implementation

Abstract

INTRODUCTION: New Zealand health policy encourages patient access to their electronic medical records via portals.AIM: To discover patient and general practitioner (GP) perspectives of access to electronic medical records and e-messaging in the early portal implementation phase. METHODS:In 2014, Auckland primary health organisations and an Accident & Medical organisation were asked to invite their GPs to complete an online survey and consent for a researcher to attend their waiting room and invite patients to complete a survey. RESULTS:In total, 421 patients (13% Maori, 18% Pacific, 7% Asian, 53% NZ European/Other) participated from 13 general practices. Most (77%) knew they were entitled to see their medical records and 90% were interested in viewing them. Over two-thirds thought that viewing their records online and e-messaging their practice was a good idea. Over 80% disagreed that they would be worried, confused or embarrassed by seeing their records, with 59% expecting portals to facilitate understanding of their medical conditions. Internet security and privacy concerned 40% of patients. Among 83 GPs who completed the survey, six (7%) had already implemented portals. Few were comfortable to open up the whole health record, especially visit notes. While GPs thought that portal access may help patients better understand their plan of care, their main concerns related to causing confusion and worry. Portal implementation was expected to change GP documentation and increase practice workload and costs without demonstrable benefit to practices. DISCUSSION:At the beginning of portal adoption, patients were interested. GPs were more reticent, unsure whether the benefits would outweigh the downsides for their patients and practice workload.

Functionalities and Issues in the Implementation of Personal Health Records: Systematic Review

“…The health record function provides patients options to view clinical documents that can be retrieved from health providers’ EHR [ 22 , 23 , 34 ]. This information can include problem lists [ 22 , 24 - 29 , 45 , 56 , 67 - 71 ], allergies [ 22 , 25 - 28 , 30 - 33 , 35 - 39 , 56 , 67 - 70 ], immunization [ 22 , 26 - 28 , 30 , 32 - 35 , 40 - 42 , 56 , 68 - 71 ], laboratory and test results [ 22 , 24 , 26 - 30 , 33 , 36 , 37 , 40 , 42 - 61 , 67 - 71 ], diagnostic information [ 32 , 37 , 44 , 45 , 62 ], discharge information [ 31 , 34 , 63 ], and clinical notes [ 24 , 30 , 33 , 42 , 50 , 61 , 64 , 67 , 69 ]. Figure 3 shows an example of test results in PittPHR [ 33 ].…”

“…The health record function provides patients options to view clinical documents that can be retrieved from health providers' EHR [22,23,34]. This information can include problem lists [22,[24][25][26][27][28][29]45,56,[67][68][69][70][71], allergies [22,25-28,30-33,35-39, 56,67-70], immunization [22,26-28,30,32-35, 40-42,56,68-71], laboratory and test results [22,24,[26][27][28][29][30]33,36,37,40,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]…”

“…Some people have concerns about storing these data online [54,103,108,113,115] and consent to use the system [116]. They may have concerns about identity theft and unauthorized access in PHRs [54,55,57,61,69]. Confidentiality and privacy of information in PHRs should be ensured through secured access to PHRs [110].…”

“…Issues in implementation of the PHR a .25,29,33,35,37-39,51,53,61-63, 68,72,76,86,88-90,96,100,102,104,106-112] Ability of PHR to share or exchange data with other systems Interoperability[25,26,[32][33][34]42,45,47,54,55,57,[60][61][62][63][64][65]69,70,[72][73][74]76,77,83,92,94,97,103,108,110,[112][113][114][115][116][117][118][119][120][121][122] Safeguarding of data and personal information in PHR Security and privacy[24,25,[33][34][35][36][37]…”

From the Editor: Food, farming and neuro-inflammation

“…5 Among the research papers in this issue are a paper comparing GPs' and patients' perceptions of patient portals (before they were widely implemented) 6 and another asking patients if they had received the information they would like about the medicines they were being dispensed. 7 Both papers found that patients would like more information than they currently receive but GPs were less enthusiastic than patients about their having full access to all their clinical records, 6 and no one was sure about where the responsibility should lie for providing the information about their medicines that patients would like. 7 Patients are unlikely to complain about these things, but the general message seems to be that one should not under-estimate patients' appetite for health information from their trusted sources in primary care.…”