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Secondary Use of Electronic Health Records to Improve Quality and Safety of Care: Healthcare Professionals' Knowledge and Concerns
28 Pages Posted: 4 Feb 2019
More...Abstract
Background: Health and social care professionals (HCP) are often patients' first point of contact in what concerns the communication of the purposes, benefits, and risks of sharing electronic health records (EHR) for non-direct care purposes. Their engagement is fundamental to ensure patients' buy-in and a successful implementation of healthcare data sharing schemes. However, their views on this subject are seldom evaluated. The aims of this work is to explore HCP' knowledge on a) the purposes of using EHR data for non-direct care, and b) their major concerns about data sharing processes.
Methods: Thirty online interviews were conducted between the 27th March and 7th April 2017 using a novel online bulletin system, and following a topic guide with open-ended questions. The transcripts were compiled verbatim and systematically reviewed by two independent reviewers, using the framework analysis method to identify emerging themes.
Findings: HCP were knowledgeable about the possible secondary uses of data and highlighted its importance for 1) patient profiling and tailored care, 2) research, 3) quality assurance, 4) public health, and 5) service delivery planning purposes. Main concerns towards data sharing included 1) data accuracy, 2) patients' willingness to share their records, 3) challenges on obtaining free and informed consent, 4) data security, 5) lack of adequacy / understanding of current policies, and 6) potential patient exposure and exploitation.
Interpretation: Although our results suggest a good understanding of the purposes of data sharing for secondary purposes, some concerns still remain. A better understanding of HCP' knowledge and concerns could inform national communication policies, and improve tailoring in order to maximise efficiency and improve patients' buy-in.
Funding: This work is supported by Imperial NIHR Patient Safety Translation Research Centre and by NIHR Imperial Biomedical Research Centre.
Declaration of Interest: We declare no conflicts of interest associated with this research.
Ethical Approval: The protocol complies with the COREQ checklist for qualitative studies. This research was part of a service evaluation and was approved by such by the Head of Regulatory Compliance, AHSC Joint Research Compliance Office Imperial College London and Imperial College Healthcare NHS Trust on the 23rd January 2017.
Keywords: Health care data, Secondary use, Quality of Health Care, Health Policy
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