Patients’ Access to Online Medical Records by 2015 in the UK: An Analysis of Comments by Online Newspaper Readers
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Abstract
Background: On 29th November 2011, the government in the United Kingdom (UK) suggested that by 2015 patients’ should have access to online medical records (OMRs) held by their general practitioners (GPs) in the National Health Service (NHS). In the recent past, a similar initiative known as the Summary Case Records (SCR) program did not succeed in the NHS in England due to several issues including limited evidence of clinical benefits, low uptake and use at the secondary care level, patients’ consent and opt out, lack of justification for the program, low demand by the user, data quality and financial constraints (Greenhalgh et al., 2010). Nevertheless, there is a renewed resolve by the UK government to provide patients with online access to their personal health records by 2015, which is in line with a similar commitment suggested by the European Commission. It is therefore expedient to know the public reaction to the above-mentioned health related policy issue.
Objectives: To study the public’s views about online access to personal health records (PHR) held by NHS GPs.
Methods: Using an innovative, inexpensive and practical source of qualitative data i.e. newspaper readers’ online comments, a thematic analysis was carried out on all online available open-ended comments (n=76) made by Individual readers (n=46) published in online editions of the Daily Telegraph, a leading national daily newspaper in the UK, from 2nd December 2011 to 29th December 2011 in the aftermath of publication of two stories related to the government announcement of providing all NHS patients access to their online GP medical records by 2015.
Results: Readers’ comments comprised positive and negative views on the UK government’s public policy of NHS patients’ access to personal OMRs by 2015. The positive views included six major themes, which were related to the policy (idea) of access to OMR (e.g. good / great idea, support it), patient’s access to OMRs (e.g. the right to access personal OMRs, OMR as a property of the patient, free of charge access and access to full and unedited medical records), the current practice of accessing OMRs (e.g. dissatisfaction and paying high costs for getting copies of PHRs), GP related issues (e.g. some GPs supporting access to OMRs, some GPs reluctant to provide copies of PHR by email, and the wrong notion that only doctors/GPs could understand health records and that patients could not), availability of the technology supporting OMRs and the use of OMRs in emergencies and overseas. The negative views comprised nine key themes, which included comments opposing the idea of OMRs (e.g. dangerous, scandal, disaster in waiting and money making rip-off), costs of OMRs (e.g. high costs, burden on taxpayers, and a need of saving money), concerns about OMR data (e.g. security, risks and misuse),access to OMR data (e.g. the right to access, types of patients, patient costs, and unauthorized access), patient oriented issues (e.g. patient held medical records, lack of understanding OMRs, lack of demand to access OMRs, the right to opt in/opt out, patients’ consent, a clear policy vis-à -vis access to OMRs and patients’ preferences), and issues related to GPs (e.g. editing of OMRs by GPs, increased demand for GP appointments and preference for GP held records over OMRs), the government (e.g. lack of confidence and trust in government authorities, OMRs as a privatization initiative, a revenue generation scheme and transfer of data from GPs to the Department of Health), the NHS (e.g. high expenditure and need for focusing on treatments and delivery of care) and the technology (e.g. a need for a reliable and universally usable software supporting OMRs).
Conclusions: The British people see some benefits as well as limitations and areas of concern in accessing their online medical (GP) records. The government needs to assure the public regarding the safety of OMR data and access rights vis-à -vis OMRs besides detailed information regarding the process of opt in and opt out of the scheme. This study has some limitations including the demographic of readers of the newspaper in which the comments were published, a lack of quantification and generalisation of findings due to the nature of the data; nevertheless, it provides important insights into the public’s views vis-à -vis access to OMRs. The findings of this study could be used as a basis for further research and in designing public information and communication strategies about online access to PHRs.
Reference:
Greenhalgh T, Stramer K, Bratan T, Byrne E, Russell J, Hinder S, Potts H. The Devil’s in the Detail: Final report of the independent evaluation of the Summary Care Record and HealthSpace programmes. London: University College London; 2010.
Objectives: To study the public’s views about online access to personal health records (PHR) held by NHS GPs.
Methods: Using an innovative, inexpensive and practical source of qualitative data i.e. newspaper readers’ online comments, a thematic analysis was carried out on all online available open-ended comments (n=76) made by Individual readers (n=46) published in online editions of the Daily Telegraph, a leading national daily newspaper in the UK, from 2nd December 2011 to 29th December 2011 in the aftermath of publication of two stories related to the government announcement of providing all NHS patients access to their online GP medical records by 2015.
Results: Readers’ comments comprised positive and negative views on the UK government’s public policy of NHS patients’ access to personal OMRs by 2015. The positive views included six major themes, which were related to the policy (idea) of access to OMR (e.g. good / great idea, support it), patient’s access to OMRs (e.g. the right to access personal OMRs, OMR as a property of the patient, free of charge access and access to full and unedited medical records), the current practice of accessing OMRs (e.g. dissatisfaction and paying high costs for getting copies of PHRs), GP related issues (e.g. some GPs supporting access to OMRs, some GPs reluctant to provide copies of PHR by email, and the wrong notion that only doctors/GPs could understand health records and that patients could not), availability of the technology supporting OMRs and the use of OMRs in emergencies and overseas. The negative views comprised nine key themes, which included comments opposing the idea of OMRs (e.g. dangerous, scandal, disaster in waiting and money making rip-off), costs of OMRs (e.g. high costs, burden on taxpayers, and a need of saving money), concerns about OMR data (e.g. security, risks and misuse),access to OMR data (e.g. the right to access, types of patients, patient costs, and unauthorized access), patient oriented issues (e.g. patient held medical records, lack of understanding OMRs, lack of demand to access OMRs, the right to opt in/opt out, patients’ consent, a clear policy vis-à -vis access to OMRs and patients’ preferences), and issues related to GPs (e.g. editing of OMRs by GPs, increased demand for GP appointments and preference for GP held records over OMRs), the government (e.g. lack of confidence and trust in government authorities, OMRs as a privatization initiative, a revenue generation scheme and transfer of data from GPs to the Department of Health), the NHS (e.g. high expenditure and need for focusing on treatments and delivery of care) and the technology (e.g. a need for a reliable and universally usable software supporting OMRs).
Conclusions: The British people see some benefits as well as limitations and areas of concern in accessing their online medical (GP) records. The government needs to assure the public regarding the safety of OMR data and access rights vis-à -vis OMRs besides detailed information regarding the process of opt in and opt out of the scheme. This study has some limitations including the demographic of readers of the newspaper in which the comments were published, a lack of quantification and generalisation of findings due to the nature of the data; nevertheless, it provides important insights into the public’s views vis-à -vis access to OMRs. The findings of this study could be used as a basis for further research and in designing public information and communication strategies about online access to PHRs.
Reference:
Greenhalgh T, Stramer K, Bratan T, Byrne E, Russell J, Hinder S, Potts H. The Devil’s in the Detail: Final report of the independent evaluation of the Summary Care Record and HealthSpace programmes. London: University College London; 2010.
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