Patient Experiences and Attitudes about Access to a Patient Electronic Health Care Record and Linked Web Messaging

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This article studies the patients’ perception regarding Web-based communication with their providers. [1]

Background

Patient access to their electronic health care record EHR and Web-based communication between patients and providers can potentially improve the quality of health care, but little is known about patients' attitudes toward this combined electronic access record.

Objective

The objective of this study was to evaluate patients' values and perceptions regarding Web-based communication with their primary care providers in the context of access to their electronic health care through a patient portal.

Methods

They conducted an online survey of 4,282 members of the Geisinger Health System who are registered users of an application (MyChart, a patient portal) that allows patients to communicate electronically with their providers and view selected portions of their EHR. To supplement the survey, they also conducted focus groups with 25 patients who were using the system and conducted one-on-one interviews with ten primary care clinicians. They collected and analyzed data on user satisfaction, ease of use, communication preferences, and the completeness and accuracy of the patient EHR.

Results

A total of 4,282 registered patient EHR users were invited to participate in the survey; 1,421 users (33%) completed the survey, 60% of them female. The age distribution of users was as follows: 18 to 30 (5%), 31 to 45 (24%), 46 to 64 (54%), 65 and older (16%). Using a continuous scale from 1 to 100, the majority of users indicated that the system was easy to use (mean scores ranged from 78 to 85) and that their medical record information was complete, accurate, and understandable (mean scores ranged from 65 to 85). Only a minority of users was concerned about the confidentiality of their information or about seeing abnormal test results after receiving only an explanatory electronic message from their provider. Patients preferred e-mail communication for some interactions (e.g., requesting prescription renewals, obtaining general medical information), whereas they preferred in-person communication for others (e.g., getting treatment instructions). Telephone or written communication was never their preferred communication channel. In contrast, physicians were more likely to prefer telephone communication and less likely to prefer e-mail communication.

Conclusion

Patients' attitudes about the use of Web messaging and online access to their EHR were mostly positive. Patients were satisfied that their medical information was complete and accurate. A minority of patients was mildly concerned about the confidentiality and privacy of their information and about learning of abnormal test results electronically. Clinicians were less positive about using electronic communication than their patients. Patients and clinicians differed substantially regarding their preferred means of communication for different types of interactions.

Comments

The use of technology in communicating between providers and patients are becoming more and more common. Although it is more efficient, we need to be careful in keeping this data secure to protect the patient’s privacy.

References

  1. Hassol, A., Walker, J. M., Kidder, D., Rokita, K., Young, D., Pierdon, S., ... & Ortiz, E. (2004). Patient experiences and attitudes about access to a patient electronic health care record and linked web messaging. Journal of the American Medical Informatics Association, 11(6), 505-513. http://jamia.oxfordjournals.org/content/11/6/505