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Online medical records with patient access: How do they affect doctors' practice, profession and patient relations?

There are significant hopes that the digitalization of working life will lead to several positive consequences for society and the public sector. For example, the Swedish Digitalization Commission argues that digitalization will be able to “streamline the public sector”, provide "better welfare services”, “facilitate audits” and “give citizens increased participation in decision-making and processes”. However, the promises of increased transparency, control and citizen participation have started to create tensions amongst professionals, experiencing challenges to their professional status.

To study such tensions this project investigates how one of the classic professions – medical doctors – respond to recent developments in Sweden whereby patients now have the possibility to read their medical records online. This development is from a political point of view framed as simply making use of new technology to improve citizens’ rightful access of information about their personal health. However, to doctors patients’ easy access to the medical record has caused ambivalence. Doctors have for instance claimed that the medical record is a tool reserved for the medical professions and have expressed concern that their record keeping will become restrained and more cautious because of patients having easy access to the notes and that this might in turn lead to threatened patient safety.

The following research questions are guiding the study:
1. How do the doctors perceive that the patients’ online access has affected their medical record-keeping and patient relationships?
2. What strategies do doctors use in relation to the online medical record in order to construct and maintain the boundaries of the profession – its autonomy, knowledge system and discretion?
3. What consequences can the doctors’ approach to the online medical record have for the patients, the doctors’ control over their professional practice and for professional development?

The project provides knowledge about how the digitalization of work life can affect professional identities. It further contributes to insights on why the digitalization of health care have turned out to be a challenge and what it is that leads to tensions between politicians’ ambitions, patients’ desires and doctors’ professional identities.

Project leader: Jesper Petersson
Project members: Jesper Petersson and Christel Backman
Duration: 2018-2020
Financier: Forte – Swedish Research Council for Health, Working Life and Welfare

Page Manager: Anders Östebo|Last update: 1/11/2019

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