ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2023
Unintended consequences of patient online access to health records: a qualitative study in UK primary care.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Impact of Digitalization on European General Practice From the Perspective of General Practitioners: Systematic Review.Journal of medical Internet research · 2026Pooled it
- Providing Mobile Patient Access to Their Electronic Secondary Care Patient Record in Adults With Cystic Fibrosis: Results of a Prospective, Parallel, Randomized Open-Pilot Quantitative Study.JMIR formative research · 2025Trial
- Access to general practice appointments and sustainable change: a focused ethnographic case study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- OpenNotes in dentistry as a strategy for patient engagement: opportunities, barriers, and a framework for implementation.Frontiers in oral health · 2026Review
- Changes in Documentation After Implementing Open Notes in Mental Health Care: Pre-Post Mixed Methods Study.Journal of medical Internet research · 2025Article
- Health Care Professionals' Perspectives on Implementing Patient-Accessible Electronic Health Records in Primary Care: Qualitative Study.JMIR medical informatics · 2025Article
- Predictive testing for Huntington's disease in a digital age; patient power with potential pitfalls.European journal of human genetics : EJHG · 2025Article
- Internet use for health information, health service utilization, and quality of care in the U.S.BMC health services research · 2025Article
- Determining implementation issues of open notes in primary care: a focus group study.BMC primary care · 2025Article
- Impact of Patient Online Record Access on Documentation: Scoping Review.Journal of medical Internet research · 2025Article
- Article
- A state-level analysis of macro-level factors associated with hospital readmissions.The European journal of health economics : HEPAC : health economics in prevention and care · 2024Article
- Exploring How Patients Are Supported to Use Online Services in Primary Care in England Through "Digital Facilitation": Survey Study.Journal of medical Internet research · 2024Article
- Views of patients with progressive illness and carers about the role of digital advance care planning systems to record and share information: A qualitative study.Palliative medicine · 2024Article
- Disclosing Results of Tests for Covert Consciousness: A Framework for Ethical Translation.Neurocritical care · 2024Review
- Improving patients' experiences of diagnosis and treatment of vertebral fracture: co-production of knowledge sharing resources.BMC musculoskeletal disorders · 2024Article
- Experiences and opinions of general practitioners with patient online record access: an online survey in England.BMJ open · 2024Article
- The NORDeHEALTH 2022 Patient Survey: Cross-Sectional Study of National Patient Portal Users in Norway, Sweden, Finland, and Estonia.Journal of medical Internet research · 2023Article
- Pathways to interoperable electronic patient records for health and social care: Part 1: for those involved directly in care.Future healthcare journal · 2023Article
- Changes in Documentation Due to Patient Access to Electronic Health Records: Protocol for a Scoping Review.JMIR research protocols · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth systems are seeking to harness digital tools to promote patient autonomy and increase the efficiency of care worldwide. The NHS Long Term Plan created the right for patients to access 'digital first' primary care by 2023-2024, including online patient access to full medical records.
aimTo identify and understand the unintended consequences of online patient access to medical records. DESIGN AND
settingQualitative interview study in 10 general practices in South West and North West England.
methodSemi-structured individual interviews with 13 patients and 16 general practice staff with experience of patient online access to health records.
resultsOnline access generated unintended consequences that negatively impacted patients' understanding of their health care, with patients finding surprising or difficult to interpret information. Online access impacted GPs' documentation practices, such as when GPs pre-emptively attempted to minimise potential misunderstandings to aid patient understanding of their health care. In other cases, this negatively impacted the quality of the records and patient safety when GPs avoided documenting speculations or concerns. Contrary to assumptions that workload would be reduced, online access introduced extra work, such as managing and monitoring access, and taking measures to prevent possible harm to patients.
conclusionThe unintended consequences described by both staff and patients show that, to achieve the intended consequences set out in NHS policy, additional work is necessary to prepare records for sharing and to prepare patients about what to expect. It is crucial that practices are adequately supported and resourced to manage the unintended consequences of online access, now that it is the default position. A table of potential unintended consequences and mitigation measures is provided to aid practice managers and clinicians implementing online access.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.