Mental Health Care Professionals’ Appraisal of Patients’ Use of Web-Based Access to Their Electronic Health Record: Qualitative Study (Preprint)

Abstract

BACKGROUND Patients, in a range of health care sectors, can access their medical health record using a patient portal. In mental health care, the use of patient portals among mental health care professionals (MHCPs) remains low. MHCPs worry that patient access to electronic health records will negatively affect the patient’s wellbeing and their own workload. This study explores the appraisal work carried out by MHCPs shortly after the introduction of online patient access and sheds light on the challenges MHCPs face when trying to make a patient portal work for them, the patient, and their relationship. OBJECTIVE This study aims to provide insights into the appraisal work of MHCPs to assess and understand patient access to their electronic health record (EHR) through a patient portal. METHODS We conducted a qualitative study including ten semi-structured interviews (N=11) and a focus group (N=10). Participants were MHCPs from different professional backgrounds and staff employees (e.g., team leaders, communication advisor). We collected data on their opinions and experiences with the recently implemented patient portal and their attempts to modify work practices. RESULTS Our study provides insights into MHCPs’ appraisal work to assess and understand patient access to the EHR through a patient portal. Four topics emerge from our data analysis: 1) appraising the effect on the patient-professional relationship, 2) appraising the challenge of sharing and registering delicate information, 3) appraising patient vulnerability, and 4) redefining consultation routines and registration practices. CONCLUSIONS MHCPs struggle with the effects of online patient access and are searching for the best ways to modify their registration and consultation practices. Our study suggests various solutions to the challenges faced by MHCPs. To optimize the effects of online patient access to EHRs, MHCPs need to be involved in the process of developing, implementing, and embedding patient portals.