TY - JOUR T1 - Unintended consequences of patient online access to health records: a qualitative study in UK primary care JF - British Journal of General Practice JO - Br J Gen Pract DO - 10.3399/BJGP.2021.0720 SP - BJGP.2021.0720 AU - Andrew Turner AU - Rebecca Morris AU - Lorraine McDonagh AU - Fiona Hamilton AU - Sarah Blake AU - Michelle Farr AU - Fiona Stevenson AU - Jon Banks AU - Helen Atherton AU - Dylan Rakhra AU - Gemma Lasseter AU - Gene Feder AU - Sue Ziebland AU - Emma Hyde AU - John Powell AU - Jeremy Horwood Y1 - 2022/09/05 UR - http://bjgp.org/content/early/2022/10/21/BJGP.2021.0720.abstract N2 - Background Health 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.Aim To identify and understand the unintended consequences of online patient access to medical records.Design and setting Qualitative interview study in 10 general practices in South West and North West England.Method Semi-structured individual interviews with 13 patients and 16 general practice staff with experience of patient online access to health records.Results Online 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.Conclusion The 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. ER -