背景:患者\'在线记录访问(ORA)使患者能够通过在线数字解决方案读取和使用其健康数据。一个这样的解决方案,爱沙尼亚已经实施了患者可访问的电子健康记录(PAEHR),芬兰,挪威,和瑞典。虽然积累的研究指出了ORA的许多潜在好处,它在精神保健(MHC)中的应用仍然存在争议。本研究旨在描述MHC用户对国家PAEHR服务的整体体验。
方法:该研究分析了NORDeHEALTH2022患者调查的MHC部分,大规模的多国家调查。调查包括45个问题,包括人口统计学变量和与ORA用户体验相关的问题。我们专注于有关积极经验(利益)的问题,负面经历(错误,遗漏,office),以及对安全和隐私的侵犯。如果参与者报告在过去两年内接受了精神保健,则将其包括在此分析中。描述性统计数据用于汇总数据,和百分比是根据现有数据计算的。
结果:包括6,157名受访者。根据以前的研究,几乎一半(45%)的人报告了ORA非常积极的经历。每个国家的大多数人还报告说,与医疗保健提供者的信任(至少69%)和沟通(至少71%)得到了改善。三分之一(29.5%)的人报告了ORA的负面经历。总的来说,一半的受访者(47.9%)发现错误,三分之一(35.5%)的受访者发现医疗文件中有遗漏。三分之一(34.8%)的受访者也表示被内容冒犯。当发现错误或遗漏时,约一半(46.5%)报告他们没有采取任何行动。患者经历错误的方式似乎有所不同,遗漏,和国家之间的信息缺失。一小部分报告了家庭或其他人要求访问其记录的情况(3.1%),大约十分之一(10.7%)的人指出,未经授权的人看到了他们的健康信息。
结论:总体而言,MHC患者报告的积极经历多于消极经历,但很大一部分受访者表示,PAEHR的内容存在问题。因此,需要进一步研究在MHC中实施ORA的最佳实践,确保所有患者都能获益,同时限制潜在的负面后果。
BACKGROUND: Patients\' online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users\' overall experiences with national PAEHR services.
METHODS: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users\' experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data.
RESULTS: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information.
CONCLUSIONS: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.