Access to records may disrupt the therapeutic relationship, particularly in the provision of mental health services. | Evidence shows that access can improve transparency and strengthen the therapeutic relationship. (7), (8) |
Unfamiliar medicolegal obligations exist with digital platforms such as portals. | The CMPA recommends the same responsibilities as with paper-based records; however, more guidance is needed for information in the digital environment. (6) |
Digital platforms pose an increased risk to privacy through unwanted proxy access and data breaches. | The CMPA provides recommendations around data encryption, cloud-based services and software updates, but more evidence is needed. (6) |
Patients may experience harm from data access, including fear or anxiety from sensitive results, before they have had an opportunity to discuss with the clinician. | Preliminary evidence does not show harm with information access through portals, but more evidence is needed. (5), (9), (10) |
Similar to electronic medical records and other digital solutions, portals may hamper workflow. | Preliminary evidence does not show workflow inefficiencies, but more evidence is needed. (11) |
Messaging functionality via portals may lead to inappropriate expectations of clinicians. | Preliminary evidence does not show an increased burden on clinicians, but more evidence is needed. (7), (12) |
Portals may increase health disparities, with few older and disadvantaged patients using them. | Theoretically possible (as with many technologies), but more evidence is needed. (12), (13) |