When will a digital NHS recognise the patient?

Very few commentators writing about how to make the NHS sustainable ever mention harnessing the power of IT-enabled patients. Still fewer take the home seriously as a place where care (perhaps the lion's share of it) occurs. If one thinks of the care continuum, it should normally start and end with the home. A sustainable health delivery model has people caring for themselves expertly at home, knowing when to call on others for help and knowing what to do once they are back home again.

How patients use access to their electronic GP record--a quantitative study.

BACKGROUND: Record access is likely to become an integral part of routine care in the UK. While existing research suggests that record access improves self-care and improves relationships between patients and clinicians, little is known about how patients make use of their ability to access their records or the impact that this has on health behaviour. AIM: To explore patients' use of access to their electronic GP record and the impact of that process on their health behaviour. METHOD: Self-administered postal questionnaire mailed from three general practice surgeries to patients registered to use PAERS record access system. Data were analysed using SPSS. Content analysis was used to analyse free-text responses. RESULTS: Two hundred and thirty-one of 610 patients responded. Frequent users of Record Access were those in poor health. Record access was used to look at test results and to read letters from those involved in health care. Forty-two per cent reported a positive impact on following medication advice and 64% a positive impact on following lifestyle advice. Just over half the sample felt accessing records prior to appointments saved time and wanted to share records with other health care providers. Approximately a third reported difficulties with understanding their records. CONCLUSIONS: Record access appears to have a number of positive outcomes and very few negative ones, although further work is needed to confirm this. It is used by patients to help practices improve efficiency and to improve compliance. It has the potential to promote and reinforce collaborative relationships between clinicians and patients.

How patients use access to their full health records: a qualitative study of patients in general practice.

OBJECTIVE: To explore how patients use record access, its impact and the benefits and drawbacks of using it. DESIGN: Qualitative study using focus group interviews, individual interviews and telephone interviews. SETTING: General practice offering electronic access to full medical records using PAERS system. PARTICIPANTS: Forty-three patients aged between 20 and 71 years participated. Of these, nine were in the healthy group, eight had long-term health conditions, 10 were in the mental health group and 16 were pregnant. RESULTS: Three themes emerged as to how patients used record access - participation in care, quality of care and self-care strategies. Record access was used to help prepare patients for consultations, compensate for poor or complex communication during consultations and to reduce the fragmentation of care. Record access had a small impact on health behavior intentions. Overall patients felt that record access reinforced trust and confidence in doctors and helped them feel like partners in healthcare. CONCLUSION: This study suggests that record access improves shared management, with patients using their records to improve interactions with healthcare providers, make decisions about their health and improve the quality of the care they receive. These findings also suggest a possible long-term potential for record access to improve health outcomes.