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Patient online a ccess to records An overview of the barriers. Paul Fleming Head of IT, Stockport PCT NIGB Presentation April 2012. The Research. Health Informatics MSc UCLAN Studied 4 practices in Stockport, Tameside & Glossop during 2011. On site semi structured interviews
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Patient online access to records An overview of the barriers Paul Fleming Head of IT, Stockport PCT NIGB Presentation April 2012
The Research • Health Informatics MSc UCLAN • Studied 4 practices in Stockport, Tameside & Glossop during 2011. • On site semi structured interviews • Practice Manager, GP and member of admin team • Quantitative data from supplier • Literature review with international scope
Emis Access usage • 2004 - Repeat medications and appointment booking • 2007 - Patient records access • 1% Practices use RA • Pockets of pioneering practices • Other suppliers developing patient access systems including hospitals.
Findings : Benefits for patients • More than 90% felt that records access benefits patients • Managing chronic illness/long term conditions • Convenience– saving the patient time and in some cases money • Being informed about your own health and increasing understanding • Patient control, responsibility and ownership • Breaking the mould of “the GP tells you” • Sharinginformation
Barriers to use and adoption • Culture • Education • Technology
The Risks • Patients understanding of what they find • Patients might not be happy with what they find • Medico-Legal risks • Third party data • Human errors leading to security risks.
Overarching barriers Culture No clear strategy (or funding) for implementation Not currently incentivised Functionality is inconsistent across suppliers High level, national standards not yet established Being scared of the unknown (patients and care providers) Lack of awareness
Recommendations • Robust policy, procedure and standards minimises risk • Train staff properly and routinely, educate patients • Have a GP Champion within each practice. • Involve clinicians and patients at the planning stage • Use multiple methods of promotion (5 or more for best results) • Screen important results first • Assess patient first (especially around mental health problems)
Recommendations cont. • Explore more centralised support functions for password resets and assistance. • Publish standards for suppliers to ensure safe, robust and available systems • Joined up approach for the future between Primary Care, Community, Acute and Local Authority
Trends in Internet Access • 73% of households connected to the Internet. • Changing consumer behaviours retail, banking, tourism. • Increase in Internet use on smart phones. • Tablets • Faster, easier, cheaper
Conclusions • Awareness levels of records access service are high within early adopter practices. • Cultures and attitudes are positive around records access within the sample practices. • Patients accessing their own records can potentially reduce administration workload within the practice setting. • There are resource overheads with implementing and providing support for online records access.
Conclusions cont. • Having a GP clinical champion leading records access increases the rate of views of online records. • There are a number of risks and benefits to records access. Risks can be mitigated by implementation of robust policy and processes. • Patients at early adopter practices are positive about records access and come from different backgrounds and age groups. • Training and education around records access within early adopter practices is not delivered formally and is adhoc in nature. • Further work is required to address technical issues with the current systems of records access.
Benefits to the Practice • 11 out of 12 felt records access benefitted practice • Saves time, cuts workload • Gives patients a better quality of service, an added service
Promoting access to patients • Clinician contacts • Posters, leaflets • Patient Participation Groups • SMS Text • Web site promotion • Newsletter, email shots • Patient display boards and TV screens • Phone messages
Aims of the research • Identify promotional strategies that have the potential to increase uptake and continual online access of medical records for patients. • Identify and explore the perceived barriers and benefits of patients accessing their records online from the practice perspective. • Identify attitudes towards patient online access to records from the perspective of different roles within general practice.