This site is intended for health professionals only

Guidance on online access to health records from researchers

26 May 2015

Share this article

Warnings about unintended harm caused by online access to health records have been issued by academics.

The Government is aiming for all adults to have online access to their health and social care records by 2020, but researchers from the Institute of Child Health, QMUL and the University of Bristol are concerned about the potential for unintended harm.

They were particularly concerned about it having an adverse effect on children, older people, those with learning difficulties and clinicians recording the data.

They recommended limiting online access to recent information that has clear medical utility, such as test results, referral letters, clinic letters, current medication and allergies.

They also suggested that online access to the full medical record should be implemented slowly, in a staged process and with thorough evaluation, in British Journal of General Practice.

The researchers were particularly concerned about the potential for coercion: patients unwillingly giving others access to their online medical record, and said that older people, teenagers and those with learning difficulties could be most at risk from this.

Prof Gene Feder, a GP and professor of primary care at Bristol’s Centre for academic primary care, said: “Coercion may result from overt threats or physical force in an abusive relationship or may appear under the guise of helping a vulnerable relative, especially older people or those with learning disabilities.”

Dr Jenny Woodman, a researcher at the UCL Institute of Child Health, said: “Current proposals suggest that parents will not have automatic access to a child’s record after they are 12-years old. However, teenagers may find it difficult to refuse parental requests for access if they are worried it may look like they have something to hide.”

Feder and his colleagues are also concerned that the clinician, worried about coercion or information leakage within households, may not record anything deemed to be sensitive, including early concerns about abuse or maltreatment. This may impact on care of the patient: recording can allow a cumulative picture of concern and judgement about how far action needs to be taken to support families or protect children.