Abstract
Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.
Highlights
Providing online access to health care records and services may improve access and the personalization of primary health care
Online access is the process of a patient, their carer, or their guardian logging on to access all or part of their electronic health record (EHR) with the ability to view, and sometimes edit or comment
This review aims to identify the key opportunities and challenges affecting online access to electronic health records and other online services in primary care
Summary
Providing online access to health care records and services may improve access and the personalization of primary health care. Online services have been described as fundamental to patient empowerment and may drive the improvement and organization of services [1,2]. Online access is the process of a patient, their carer, or their guardian logging on to access all or part of their electronic health record (EHR) with the ability to view, and sometimes edit or comment. Linked online services enable patients to communicate with their general practice, doctor, or other health care worker by email or through a web portal. Online services include tasks such as booking appointments or requesting repeat prescriptions (prescription refills) without seeing their doctor. Online access and services can be accessible from a patient’s home, workplace, or mobile computing device
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