Continuity of information in general practice - Patient views on confidentiality

Objectives - To explore patient views on access to a variety of information in the medical record by the on-call general practitioner and by the practice assistant in relation to the perceived importance of this information for the personal doctor. To relate patient views to patient and practice characteristics. Design - Postal questionnaire survey. Setting - General practice. Subjects - 873 patients from 35 general practices dispersed throughout The Netherlands. Results - 20% of the patients stated that the on-call GP should not have access to their entire medical record and 44% did not support full access for the practice assistant Patient consent to the on-call GP being allowed to access a variety of information ranged from 62% for life events to 93% for medication; and to the practice assistant from 37% for home details to 82% for medication. Patients distinguished between "medically oriented information" and "lifestyle and psychosocial information". Their views could hardly be explained by patient and practice characteristics. Conclusion - Patient consent to access their medical record should not be taken for granted. We need research on the effectiveness of accessible prior knowledge, and on possibilities to segregate information. Patients should be informed more fully about everyday practice.