Impact on documentation practices and patient-provider relationship when mental health patients access their electronic health records online: a mixed-method study among health professionals (PSYKISK INNSYN)
Description
Patient accessible electronic health records (PAEHR) is offered to residents of Helse Nord, Helse Vest and Helse Sør-Øst through the national health portal helsenorge.no. Research shows that PAEHR can contribute to increased patient empowerment. Information accessed by patients may enable them to better understand their health status and health care processes. This is especially true for patients with complex, long-term and chronic illnesses. For patients in mental health care, the findings are not as concise and clear.
Concerns have been expressed by health professionals in mental health care about the consequences of giving patients online access to their records. Health professionals fear that PAEHR will increase their workload, change the patient-provider relationship, pose a security risk and create unnecessary worry and misunderstandings as patients can read the records alone without guidance.
Previous research showed that mental health professionals have changed the way they write in the electronic health records after the introduction of the PAEHR. This project investigates such topics in greater detail, and with a focus on mental health.
Goals
The impact of PAEHR among health professionals working in mental health will be addressed through three objectives:
1) to study changes in patient-provider relationship;
2) to study changes in the way health professionals write in the EHR,
3) to study practices used by health professionals to deny access to information in the EHR.
Method
A combination of qualitative and quantitative methods will be used to address the study objectives.
In the first part of the project, in-depth qualitative interviews will be conducted in the first phase of the project with health professionals working with patients in mental health to collect detailed information of a qualitative nature on the impact of PAEHR in terms of patient-provider relationship, changes in the way of writing in the electronic health records and reasons for denying access to information.
In the second part of the project, we will conduct a content analysis of electronic health records in mental health, where we compare electronic health records before and after patients were offered online access to their electronic health records. The content analysis will look at changes in word use, length of text, etc. Natural language processing will be used to analyze and compare records from around 40 patients.
In the third and final part of the project, we will investigate health professionals' use of informal and formal methods to make information inaccessible to patients. We will conduct a quantitative survey, in addition to analyzing reports on denied access to information.
