• Zoë Fritz, Alex Schlindwein, and Anne-Marie Slowther.
• Wellcome fellow in society and ethics, The Healthcare Improvement Studies (THIS) Institute, Cambridge, UK and Warwick Medical School, Coventry, UK zoe.fritz@addenbrookes.nhs.uk.
• Clin Med (Lond). 2019 Sep 1; 19 (5): 386391386-391.

BackgroundPatient and professional views about the impact of providing full real-time access to the medical record in the in-hospital setting are unknown.MethodsLikert-scale and free-text validated questionnaire survey of physicians and patients from acute medical units in two hospitals. The questionnaire explored recent experiences; views on the formation of trust, and views on sharing either the entire medical record or a summary.ResultsTwo-hundred and forty-eight patient questionnaires (62% response rate) and 32 physician questionnaires (21% response rate) were returned. Twenty-seven per cent of patients did not recall being told their diagnosis. Doctors and patients differed on what practices that they believed built trust.Eighty-one per cent of patients supported the idea of having access to the full medical record (for empowerment; the right to information about oneself; as an aide-memoire for discussion). Doctors feared it might provoke anxiety and change the nature of what was written. A written lay summary record was preferred by doctors and patients.ConclusionsThe current system of providing information verbally to patients is inadequate. Patients want more information and are less concerned than physicians about potential negative effects of real-time access to their records. Patient access to medical records (in both full and summary forms) should be evaluated.© 2019 Royal College of Physicians.

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