What doctors fear when patients can access their medical records freely


A large majority of English doctors feel that patients will worry more, as well as find their medical records more confusing than helpful, if they have access to those records. — Filepic

Most family doctors surveyed in England fear that giving patients online access to their medical records will increase their workload and the risks of litigation.

This was suggested by the results of the largest study of its kind, published Feb 1 (2024) in the open access journal BMJ Open.

However, a significant proportion did also agree that there would be benefits for patients.

Among the 400 general practitioners (GPs) who responded to the survey, seven out of 10 agreed that patients would better remember their care plan, while six out of 10 respondents believed that access would help patients feel more in control of their care.

But 91% felt that patients would worry more as a result, while 85% thought patients would find their GP records more confusing than helpful.

And six in 10 believed that most patients would find significant errors in their records.

An increase in workload and potential litigation were also major concerns for respondents.

An overwhelming majority (89%) believed that they will, or already, spend more time addressing patients’ questions outside of consultations as a result, and that consultations will/already take significantly longer (81%).

Of further concern is that nearly three out of four doctors (72%) said they will be/already are less candid in their documentation as a consequence of the move.

And nearly two-thirds (62%) felt the risks of litigation would increase.

“We emphasise that studies of patients’ experiences in diverse countries question the robustness of this perspective,” write the study authors.

“However, it will be important for ongoing studies in the United Kingdom to evaluate and continue to assess both GPs’ and patients’ experiences with access.”

But like it or not, “in England, patients’ online access to their GPs’ records is here to stay,” they add.

“In the coming months, it will be crucial for GPs, primary care staff and patients to adapt to this radical change in practice.”

According to the study, the National Health Service England (NHSE) announced in 2021 that patients aged 16 and over would have access to information added to their online primary care records from that time onwards by default.

While the GP contract in England has required doctors to offer new patients full prospective online access to their records since April 2019, this was widely interpreted to mean access would be granted only after a patient request to their GP.

On March 6, 2023, NHSE announced a new GP contract that would impose online record access by default by that October.

However, by November – a month after default access (i.e. without the need for a request) was mandated – one in four GP clinics across England still did not offer it.

Patients should have access to their medical test and lab results, secondary care letters, medication lists, and the free text (notes) written by GPs during consultations, via online services such as the NHS app.

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