Clinician Experiences of Patient Access to Health Records - An Interview Study in Home Dialysis Care

Patient-accessible electronic health records (PAEHRs) are regarded as a means to empower patients, especially those with chronic conditions, to take greater responsibility for their own health. However, clinicians often express concerns that PAEHRs may negatively impact their work and patient care, particularly if patients misinterpret their data. We investigated how clinicians working in home dialysis care for patients with chronic kidney disease experienced PAEHRs. Eleven clinicians participated in semi-structured interviews. The effects of PAEHRs varied depending on the patient and their circumstances. When the patient was knowledgeable and motivated, PAEHRs were seen to reduce clinicians' workload and improve communication. Conversely, the impacts were negative with patients who were already anxious or otherwise had challenges in understanding their data. Although home dialysis patients are generally considered more capable of taking responsibility for their own health than the average patient, the challenges reported by clinicians were similar to those observed in previous studies involving other patient groups. PAEHRs should be examined from a socio-technical systems perspective, taking into account patients' situations, capabilities, and experiences, and the communication between patients and clinicians. Further research is needed to explore the socio-technical aspects that influence the impact of PAEHRs on clinicians' work with individuals who have chronic conditions requiring significant patient involvement, such as home dialysis.