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Patients' web-based access to their medical records is expected to promote their role and responsibility in managing their own health and treatments and supporting shared decision-making. As of July 2020, general practices in the Netherlands are legally obliged to provide their patients access to their electronic medical records. Web-based access provision is facilitated and stimulated through a national support program named OPEN. We aimed to investigate general practice staff experiences with providing web-based access; investigate its impact on patient consultations, administrative actions, and patient inquiries; and investigate how it affects routine general practice workflow processes. In October 2021, a total of 3813 general practices in the Netherlands were invited to complete a web-based survey that included questions regarding their experiences with the provision of web-based access to medical records and how it affects routine general practice workflow. Responses of general practices that started providing web-based access before 2020, in 2020, or in 2021 were analyzed to identify trends. Of 3813 invited general practices, 523 (13.72%) completed the survey. Approximately all responding general practices (487/523, 93.1%) indicated that they provide web-based access. Experiences with patients' web-based access were diverse, with 36.9% (178/482) primarily positive, 8.1% (39/482) primarily negative, 42.3% (204/482) neutral, and 12.7% (61/482) could not (yet) indicate how they experienced web-based access. Of the total, two-thirds (311/473, 65.8%) reported an increase in e-consultations and a similar percentage (302/474, 63.7%) indicated an increase in administrative actions associated with web-based access provision. A small proportion of the practices (≤10%) experienced a decrease in patient contacts. Earlier adoption of web-based access was associated with a more positive attitude toward web-based access and more positive experienced effects related to patient contacts and general practice workflow. The surveyed general practices mainly experienced providing web-based access as either neutral or mostly positive, despite an increased number of patient contacts and administrative burden that were associated with its adoption. Periodic monitoring of experiences is needed to understand the temporal or structural nature of both the intended and unintended effects of patients' web-based access to medical records for general practices and their staff.

In the wake of the COVID-19 pandemic, video consultation was introduced in general practice in many countries around the world as a solution to provide remote health care to patients. It was assumed that video consultation would find widespread adoption in post–COVID-19 general practice. However, adoption rates remain low across countries in Northern Europe, suggesting that barriers to its use exist among general practitioners and other practice staff. In this viewpoint, we take a comparative approach, reflecting on similarities and differences in implementation conditions of video consultations in 5 Northern European countries’ general practice settings that might have created barriers to its use within general practice. We convened at a cross-disciplinary seminar in May 2022 with researchers and clinicians from 5 Northern European countries with expertise in digital care in general practice, and this viewpoint emerged out of dialogues from that seminar. We have reflected on barriers across general practice settings in our countries, such as lacking technological and financial support for general practitioners, that we feel are critical for adoption of video consultation in the coming years. Furthermore, there is a need to further investigate the contribution of cultural elements, such as professional norms and values, to adoption. This viewpoint may inform policy work to ensure that a sustainable level of video consultation use can be reached in the future, one that reflects the reality of general practice settings rather than policy optimism.

Background Sharing of patient electronic health record (EHR) data between healthcare providers can enhance quality and efficiency of healthcare provision, and patient safety. Health information exchange is allowed only with explicit patient consent. In the Netherlands, patient consent and the exchange of information is organized nationally. Consent status is recorded routinely in general practice EHRs. This study examines how various characteristics at the individual and general practice level influence this consent for electronic health information exchange (HIE). Methods Routine EHR data from general practices and out-of-hours primary care services participating in the Nivel Primary Care Database were analysed for the period 2017–2019, just before the coronavirus disease 2019 (COVID-19) pandemic outbreak. Bivariate chi-squared test analysis and multilevel logistic regression analysis, adjusted for practice-level clustering, were conducted for each of the 3 observed years to assess whether consent for electronic HIE (“yes” or “no”) was associated with the individual’s health and healthcare utilization, demographics, neighbourhood characteristics (socioeconomic position, degree of urbanization, area deprivation), and general practice characteristics (practice type, EHR system, practice size). Results Between 2017 and 2019, 38–45% of the individuals provided consent for electronic HIE. Individuals with a higher number of different prescriptions or those with long-lasting health problems or chronic diseases had lower odds of providing consent, in each of the 3 years. This result also applied to female and older individuals (aged ≥ 65 years). In contrast, individuals from below-average socioeconomic position neighbourhoods living in deprived urban or hardly urbanized regions generally had higher odds of providing consent. Conclusions In contrast to what was expected, patient groups with higher healthcare utilization were less, or as likely to provide consent for HIE compared with individuals with no or lower healthcare utilization. This implies that the population most likely to benefit from HIE is, in fact, less likely to profit from it. Further research is needed to determine whether these differences arise from individual trust, privacy concerns, transparency issues or other factors such as physicians’ HIE beliefs. Optimizing the national HIE system in the Netherlands requires considering multiple influencing factors, on both the individual level and practice level.

Background In recent years, eHealth has received much attention as an opportunity to increase efficiency within healthcare organizations. Adoption of eHealth might consequently help to solve perceived health workforce challenges, including labor shortages and increasing workloads among primary care professionals, who serve as the first point of contact for healthcare in many countries. The purpose of this systematic review was to investigate the impact of general eHealth use and specific eHealth services use on general practice workload in the pre-COVID-19 era. Methods The databases of CINAHL, Cochrane, Embase, IEEE Xplore, Medline ALL, PsycINFO, Web of Science, and Google Scholar were searched, using combinations of keywords including ‘eHealth’, ‘workload’, and ‘general practice’. Data extraction and quality assessment of the included studies were independently performed by at least two reviewers. Publications were included for the period 2010 – 2020, before the start of the COVID-19 pandemic. Results In total, 208 studies describing the impact of eHealth services use on general practice workload were identified. We found that two eHealth services were mainly investigated within this context, namely electronic health records and digital communication services, and that the largest share of the included studies used a qualitative study design. Overall, a small majority of the studies found that eHealth led to an increase in general practice workload. However, results differed between the various types of eHealth services, as a large share of the studies also reported a reduction or no change in workload. Conclusions The impact of eHealth services use on general practice workload is ambiguous. While a small majority of the effects indicated that eHealth increased workload in general practice, a large share of the effects also showed that eHealth use reduced workload or had no impact. These results do not imply a definitive conclusion, which underscores the need for further explanatory research. Various factors, including the study setting, system design, and the phase of implementation, may influence this impact and should be taken into account when general practices adopt new eHealth services. Study registration number PROSPERO (International Prospective Register of Systematic Reviews) CRD42020199897; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=199897 .

Correction: Health Research Policy and Systems (2025) 23:103 https://doi.org/10.1186/s12961-025-01377-x Following publication of the original article [1], a typographical error in Table 2. Age category (years), n (%) ≤ 11 19 169 (10.9) 18 694 (11.2) 29 069 (11.1) 12–15 8505 (4.9) 8078 (4.8) 12 589 (4.8) 16–24 19 230 (11.0) 18 156 (10.8) 28 595 (10.9) 25–34 18 865 (10.8) 18 103 (10.8) 28.471 (10.8) 35–44 19 390 (11.1) 18 874 (11.3) 30.123 (11.5) Correct Table 2 Section Age category (years), n (%) ≤ 11 19 169 (10.9) 18 694 (11.2) 29 069 (11.1) 12–15 8505 (4.9) 8078 (4.8) 12 589 (4.8) 16–24 19 230 (11.0) 18 156 (10.8) 28 595 (10.9) 25–34 18 865 (10.8) 18 103 (10.8) 28 471 (10.8) 35–44 19 390 (11.1) 18 874 (11.3) 30 123 (11.5) Correction Open access Published:28 August 2025 Correction: Determinants of consent for electronic health information exchange: an observational retrospective study Jelle Keuper 1,2, Karin Hek1, Lilian H. D. van Tuyl1, Ronald Batenburg1,3 & … Robert Verheij1,2,4 Show authors Health Research Policy and Systems volume 23, Article number: 106 (2025) Cite this article 102 Accesses Metrics details The Original Article was published on 07 August 2025 Correction: Health Research Policy and Systems (2025) 23:103 https://doi.org/10.1186/s12961-025-01377-x Following publication of the original article [1], a typographical error in Table 2.

The COVID-19 pandemic has forced general practices to search for possibilities to provide healthcare remotely (e.g., e-health). In this study, the impact of the pandemic on the use of e-health in general practices in the Netherlands was investigated. In addition, the intention of practices to continue using e-health more intensively and differences in the use of e-health between practice types were investigated. For this purpose, web surveys were sent to general practices in April and July 2020. Descriptive data analysis was performed and differences in the use of e-health between practice types were tested using one-way ANOVA. Response rates were 34% (n = 1433) in April and 17% (n = 719) in July. The pandemic invoked an increased use of several (new) e-health applications. A minority of practices indicated the intention to maintain this increased use. In addition, small differences in the use of e-health between the different practice types were found. This study showed that although there was an increased uptake of e-health in Dutch general practice during the COVID-19 pandemic, only a minority of practices intends to maintain this increased use in the future. This may point towards a temporary uptake of digital healthcare delivery rather than accelerated implementation of digital processes.

The first outbreak of the COVID-19 pandemic led to the introduction of the more extensive use of e-health in Dutch general practices. The objective of this study was to investigate the experiences of general practitioners (GPs) regarding this change. In addition, the necessary conditions for e-health technology to be of added value to general practices were explored. In April 2020, 30 GPs were recruited for in-depth interviews via a web survey which contained questions regarding the use of e-health during the first wave of the pandemic. While most GPs intend to keep using e-health applications more extensively than before the pandemic, the actual use of e-health depends on several factors, including the characteristics of the application’s users. The following conditions for successful and sustainable implementation of e-health were identified: (1) integration of e-health technology in the organization of GP care, (2) sufficient user-friendliness of applications as well as digital skills of professionals and patients, and (3) adequate technological and financial support of e-health services. GPs clearly recognize the benefits of using e-health, and most GPs intend to keep using e-health applications more extensively than before the pandemic. However, improvements are needed to allow widespread and sustainable adoption of e-health technology in general practices.

Samenvatting Digitalisering en technologische innovaties spelen een steeds prominentere rol in de gezondheidszorg. Het gebruik van digitale technologieën in de gezondheidszorg, ook wel bekend als e‑health of digitale zorg, heeft de potentie om de toegankelijkheid, efficiëntie en kwaliteit van zorg te verbeteren. Om de potentie van e‑health te kunnen realiseren, is het essentieel dat technologieën voor zo veel mogelijk inwoners toegankelijk zijn. Recente nationale gegevens van de E‑healthmonitor van 2023 laten zien dat hier nog verbetering mogelijk is.