The patient's perspective of computerised records: a questionnaire survey in primary care.

BACKGROUND The general practice consultation today has become a three-way process where patient, doctor and computer interact. Some studies have shown that the introduction of the computer has caused concern to some patients, possibly affecting their behaviour. If patients are less frank about their problems in a computer-mediated consultation this may cause concerns among doctors and become a barrier to computer use. OBJECTIVES A questionnaire was developed to test the prevalence of worries among patients about confidentiality breaches of computer records and to identify whether those worries translated into a reduction in patients' frankness. RESULTS The study had a 62% response rate. Almost 48% of responders had experienced confidentiality worries during past consultations. All responders denied withholding any relevant information from their general practitioner (GP) as a result of confidentiality worries. Gender, computer literacy, knowledge of computer uses in consultation and patients' perceptions of computer record safety were selected covariates in the multivariate logistic regression model explaining patients' worry. Thirty-three percent of patients stated they always understand what their GP is doing at the computer during consultation, 9.7% stated they did not ever know; though 64% judged it important to know what their GPs were doing. CONCLUSIONS Patients worry about the confidentiality of their computer record and it seems that those less familiar with computers, females and those less aware of their GP's actions at the computer worry more. Patients' understanding of their GPs' actions at the computer during consultation is far from complete and they seem to place great importance on this. Those patients who place greatest importance on needing an understanding of their GP's actions are those most likely to worry about confidentiality.