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The Access Study - Evaluation of patient access to medical test results in general practice: a mixed methods study

Lead researcher

Set of icons depicting aspects of medical care


About the project  

Current NHS drives and initiatives mean that general practice patients in England are increasingly being offered the opportunity to access medical test results electronically, through online access and other methods such as text messaging. 

Providing patients with the option to have direct electronic access to their medical test results might lead to better health outcomes, increased service satisfaction and health literacy levels, and reduce misunderstanding between patients and doctors that may result in litigation. However, it may also have the potential to result in unintended negative consequences, and the evidence on both sides is currently limited. 

Employing a realist evaluation methodology, a team of researchers from the University of Bristol are aiming to develop robust research evidence around whether patients having electronic access to test results is associated with better health and health care and how it impacts on service efficiency in primary care.

Project aims

The Access study aims to:

  • describe the range of services currently being offered to provide electronic medical test results to general practice patients in England
  • understand patient and general practice staffs’ experiences, attitudes and perceptions of different test result services
  • develop a framework to assess the economic impact of adopting these services.

To address these aims the project has three phases:

Phase 1. Survey and retrospective work

In the first phase of the study we developed a questionnaire to investigate the different types of electronic test result services offered in primary care, which was disseminated to general practices in all 15 Local Clinical Research Networks in England. 

We are also undertaking a retrospective cohort secondary data analysis of all patients (18+ years) registered between 1 August 2018 and 1 August 2019 in a diverse sample of general practices in England. This will enable us to find out whether patients who access their electronic medical test results differ from those patients who do not access these services. 

Phase 2. Qualitative work

To help us understand the views and experiences of general practice staff and patients concerning electronic medical test result services we will undertake qualitative work in diverse general practices across England. In each practice the study team will:

  • carry out observations to help identify how electronic medical test result services are incorporated into routine practice
  • undertake semi-structured interviews with general practice staff to explore their experiences and views about patient electronic access to results
  • interview patients to understand their experiences and views of using (or not) electronic medical test services offered by their practice, and to identify facilitators or barriers to their use.

Phase 3. Economic evaluation

We will use the information from Phases 1 and 2 to develop an economic framework, which could be used to conduct a full economic evaluation of patient electronic access to test results in the future.

Anticipated impacts

Our findings will contribute significantly to the currently limited evidence base on the costs and benefits of patient electronic access to medical test results. Our work will enable policy makers and the NHS to consider how best to implement electronic resources in order to benefit patients and GP practice workflow and to improve health. 

Funder

This research is funded by a Policy Research Programme grant from the Department of Health and Social Care (Ref: PR-R17-0916-14006).

Project dates 

April 2018 to April 2020.

Research team at the University of Bristol

Gemma Lasseter, Dr (Principal Investigator) 

Hannah Christensen, Dr (Lecturer in Infectious Disease Mathematical Modelling)

Richard Huxtable, Professor (Professor of Medical Ethics and Law)

Christie Cabral, Dr (Social Anthropologist and Qualitative Research Fellow)

Alastair Hay, Professor (GP and Professor in Primary Care)

Ludivine Garside, Dr (Senior Research Associate – Quantitative Methods)

Emma Johnson, Dr (Senior Research Associate – Qualitative Methods)

Cecily Palmer, Dr (Senior Research Associate – Qualitative Methods)

Further information

Further information about the project is available from the University of Bristol's Centre for Academic Primary Care website.