Retired doctors as users of patient-facing electronic health records: a mixed-methods survey in the UK and Spain

Background
Online patient access to electronic records is expanding internationally but remains contested. Although practising clinicians’ concerns are well documented, less is known about the views of retired doctors who are more likely themselves to be patients. We explored the experience of retired doctors in accessing their own medical records as patients in the UK and Spain.

Methods
We conducted an anonymous mixed-methods online survey of retired doctors aged 60 years and over in the UK and Spain. Participants reported their experiences of accessing their own medical records and their views on whether online access should be available to all patients. Quantitative analyses examined factors associated with support; free-text responses were analysed thematically.

Results
Two hundred retired doctors participated (UK n=92; Spain n=108). Overall, 64% supported online access to health records for all patients, with no clear difference between countries. This proportion was higher than that reported in a previous survey of practising general practitioners in England, in which approximately one-third regarded online record access as a good idea; however, the studies involved different populations and sampling approaches and were not designed for a formal comparison. In adjusted analysis, having previously accessed one’s own medical record was associated with greater support for online access for all patients (odds ratio 4.74, 95% confidence interval 1.80–12.53). Age, gender, former professional setting and country showed no clear independent associations with support. Participants described benefits including patient empowerment, transparency, error correction and greater efficiency, alongside concerns about misinterpretation, anxiety and handling of sensitive information.

Conclusions
In this cross-sectional convenience sample, retired doctors were more supportive of online access to health records than practising English GPs have reported in previous surveys. This cross-study difference cannot establish whether attitudes differ because of retirement, patient experience, professional role, sampling or other contextual factors. However, the association between having accessed one’s own record and support for access is consistent with the hypothesis that experience from the patient perspective may influence professional attitudes. Prospective comparative research is needed to examine this temporal relationship and to assess how record presentation and explanatory support affect patient and clinician experiences.