Do patients access electronic medical test results services in General Practice in England?

Problem

Providing healthcare medical test results to patients is a key service offered by general practices. These test results are routinely provided to patients during clinical consultations or via discussion with reception staff. However, it has been argued that delivering test results electronically may improve health outcomes and service satisfaction, promote health literacy and reduce misunderstanding between patients and doctors that may otherwise result in litigation. Despite these claims, there remains a paucity of empirical research in this area and thus there is a lack of evidence on patient outcomes and other potential benefits attributed to electronic test results services.

Approach

Using a realist evaluation approach, our research aims to find out what types of electronic test results services are currently being used by general practices in England. We also plan to gauge patient and GP practice experiences of these systems, and draw together the types of costs and benefits linked to electronic test results services. To do this our project has three phases. In the first phase we have developed a questionnaire, which has been sent to a sample of practices across England to identify what electronic test results services are currently being offered to patients and by what types of practices. We will also obtain pseudoanonymised patient records from a sample of practices and compare patients who use electronic test results services to those patients who do not, with respect to socio-demographic characteristics and health conditions. In the second phase we will conduct qualitative interviews with patients and general practice staff to find out their experiences and views of using (or not) electronic test results services offered by their practice, and any associated facilitators or barriers. This will be complemented by qualitative observations to help identify how test results services are incorporated into routine practice. Finally, we will draw the questionnaire, patient data and interview information together to develop a framework which could be used to conduct an economic evaluation in the future.

Findings

This is ongoing research. We are currently recruiting practices across England to complete the questionnaire survey. This will inform the data extraction strategy and practice selection for the retrospective data analysis. Interview topic guides have been developed and piloted, in readiness for qualitative work in the coming months.

Consequences

Patient Online is a programme instigated by NHS England and aims to enable general practices in England to offer their patients access to their medical records, online appointments, ordering of repeat prescriptions and online test results. The roll out of these services across England is part of strategic plans for modernising Primary Care. Our results will be of use to policy makers and practices looking to roll-out electronic access of test results to patients in the best way possible.