Patients Want More Access to, Control of Medical Records

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patient access EMRs, American Medical Software

December 19, 2011 — Patients are more enthusiastic about reading what their physicians are writing about them than physicians are about allowing patients to access their electronic health records, according to a study published in the December 20 issue of the Annals of Internal Medicine. In addition, American military veterans are highly enthusiastic about sharing their medical information with family members, caregivers, or physicians outside the Veterans Health Administration (VHA), according to a second study published in the same issue.

“We believe that the direction is clear: Technology is a powerful tool that can improve transparency in health care,” Thomas W. Feeley, MD, from the University of Texas M.D. Anderson Cancer Center, Houston, and Kenneth I. Shine, MD, from the University of Texas System, Austin, write in an accompanying editorial. “Electronic health records should be used to engage patients, their caregivers, and others in the health care delivery system.”

In the first study, researchers led by Jan Walker, RN, MBA, from Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School, Boston, Massachusetts, surveyed patients and primary care physicians in Massachusetts, Pennsylvania, and Washington. The 3 study populations included patients of BIDMC and associated clinics in the Boston area; patients of the mostly rural Geisinger Health System in Danville, Pennsylvania; and adult patients and patients with HIV from the Harborview Medical Center in Seattle, Washington. There were 114 participating primary care physicians, and 37,856 patients completed surveys.

The researchers surveyed physicians and patients before their joining a voluntary program that allowed patients access to physicians’ electronic notes. The researchers asked physicians and patients about their views on patient access to personal health records that included physicians’ notes about visits, which patients accessed through a Web portal. The records also contained such information as prescribed medicine lists, appointment schedules, and secure messages.

“The enthusiasm of patients exceeded our expectations; most of them were overwhelmingly positive about the prospect of reading visit notes, regardless of demographic or health characteristics,” Ms. Walker and colleagues write. Although they observed “striking differences” between physician and patient attitudes, the physicians who participated in the study “were more optimistic” that access would improve benefits than the researchers expected. Physicians who declined to participate in the voluntary electronic records program cited possible adverse effects such as patient confusion, which could lead to longer visits.

In the second study, researchers led by Donna M. Zulman, MD, from the Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, California, surveyed 18,471 patients who use the VHA’s “MyHealtheVet” Web portal to access information such as laboratory test results and provider notes. Using MyHealtheVet, patients can create their own personal health record and track self-entered health information and medications, and they also can communicate with their physicians through the portal. To track the system’s effectiveness, the VHA uses the American Customer Satisfaction Index survey. The researchers added custom questions to that survey from July 7 through October 4, 2010.

Almost 80% of the survey respondents would share their health information with designated individuals outside of the VHA, including relatives, caregivers, and other physicians. The most interest was in medication lists, laboratory test results, and appointment information, and many would name a person who could authorize refilling of prescriptions.

“Privacy concerns and compliance with the Health Insurance Portability and Accountability Act of 1996 seemed to surface in all such discussions,” the editorial authors write. “However, patients have the right to view their own medical record and should be allowed to control who sees it.”

Source:; Larry Hand; December 19, 2011

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