Providing patients with online access to their GP records has unintended negative consequences that limits its usefulness, primary care researchers have concluded.
It includes patients coming across surprising or distressing information or finding their health records difficult to interpret, the researchers from Bristol University reported in the British Journal of General Practice.
And there are unintended consequences for general practices with online access which could affect how GPs write their notes and add to administrative workloads, they said.
It comes amidst chaos and confusion over the Citizen’s Access Programme which was set to enable all patients to view their prospective record through the NHS App from 1 November.
The BMA has advised practices to bulk opt-out patients from the automatic access until sufficient safety checks are completed – either by instructing their IT supplier not to switch on the functionality or by applying a SNOMED exclusion code to patient records.
But NHS England said that GP practices that have instructed their supplier not to go ahead will still see the functionality switched on later this month, although it will not apply to records with the SNOMED code applied.
The researchers said their NIHR-funded study would help identify and understand the unintended consequences of online access so they can be managed effectively by policymakers and practitioners.
They interviewed 13 patients and 19 general practice staff across 10 general practices with experience of patient online access to health records, in South West and North West England in 2019.
The intended consequences are to help patients improve control of their health, increase efficiency of care and cut practice workload, they said.
But they said it also led to GPs avoiding documenting their speculations or concerns ‘which could have negative medicolegal and patient safety consequences’.
Online access also introduced additional work around managing and monitoring access and taking measures to prevent possible harm to patients.
As a result they said it is crucial that general practices are adequately supported and resourced to manage the unintended consequences of online access now that it is the default position.
Dr Andrew Turner, senior research associate in the Centre for Academic Primary Care at Bristol University, said: ‘Giving patients online access to their health records can be of benefit to patients and is a sign of transparency in medicine, but it is important to share access in ways that maximise the positive benefits and minimise possible harms.’
Study lead Professor Jeremy Horwood, professor of social science and health, added: ‘Implementation of online record access is more complex than the intended consequences set out in NHS policy.
‘To achieve intended consequences additional work is necessary to prepare records for sharing and prepare patients about what to expect from their records.
‘It is vital that GP practices are adequately supported to be able to implement the roll out of patient access to medical records.’