Giving rheumatology patients online home access to their electronic medical record (EMR): advantages, drawbacks and preconditions according to care providers

Technology enables patients home access to their electronic medical record (EMR), via a patient portal. This study aims to analyse (dis)advantages, preconditions and suitable content for this service, according to rheumatology health professionals. A two-phase policy Delphi study was conducted. First, interviews were performed with nurses/nurse practitioners (n = 9) and rheumatologists (n = 13). Subsequently, collected responses were quantified, using a questionnaire among the interviewees. The following advantages of patient home access to the EMR were reported: (1) enhancement of patient participation in treatment, (2) increased knowledge and self-management, (3) improved patient–provider interaction, (4) increased patient safety, and (5) better communication with others. Foreseen disadvantages of the service included: (1) problems with interpretation of data, (2) extra workload, (3) a change in consultation content, and (4) disturbing the patient–provider interaction. Also, the following preconditions emerged from the data: (1) optimal security, (2) no extra record, but a patient-accessible section, (3) no access to clinical notes, and (4) a lag time on the release of lab data. Most respondents reported that data on diagnosis, medication, treatment plan and consultations could be released to patients. On releasing more complex data, such as bodily examinations, lab results and radiological images the opinions differed considerably. Providing patients home access to their medical record might be a valuable next step into patient empowerment and in service towards the patient, provided that security is optimal and content and presentation of data are carefully considered.

[1]  Brian Fisher,et al.  How patients use access to their electronic GP record--a quantitative study. , 2011, Family practice.

[2]  Charles Safran,et al.  Improving personal health records for patient-centered care , 2010, J. Am. Medical Informatics Assoc..

[3]  Amy Butros,et al.  Research Paper: Giving Patients Access to Their Medical Records via the Internet: The PCASSO Experience , 2002, J. Am. Medical Informatics Assoc..

[4]  Ana Silva,et al.  Why facilitate patient access to medical records. , 2007, Studies in health technology and informatics.

[5]  Matthias Schneider,et al.  Changing attitudes towards online electronic health records and online patient documentation in rheumatology outpatients. , 2010, Clinical and experimental rheumatology.

[6]  B. Fisher,et al.  How patients use access to their full health records: a qualitative study of patients in general practice , 2009, Journal of the Royal Society of Medicine.

[7]  Benita Cox,et al.  Potential impacts of patient access to their electronic care records. , 2005, Informatics in primary care.

[8]  Alan Cardoso,et al.  The Access to Medical Records: a systematic review , 2006 .

[9]  C. Drossaert,et al.  Patient preferences for a hospital-based rheumatology Interactive Health Communication Application and factors associated with these preferences. , 2011, Rheumatology.

[10]  M. Patton,et al.  Qualitative evaluation and research methods , 1992 .

[11]  Kevin J. Leonard,et al.  Application of Information Technology: Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records: A Critical Review and Proposal for an Evaluation Framework , 2004, J. Am. Medical Informatics Assoc..

[12]  J. Weissman,et al.  Comparing Patient-Reported Hospital Adverse Events with Medical Record Review: Do Patients Know Something That Hospitals Do Not? , 2008, Annals of Internal Medicine.

[13]  David Carrell,et al.  Research Paper: Patient Web Services Integrated with a Shared Medical Record: Patient Use and Satisfaction , 2007, J. Am. Medical Informatics Assoc..

[14]  Chen-Tan Lin,et al.  Expectations of Patients and Physicians Regarding Patient-Accessible Medical Records , 2005, Journal of medical Internet research.

[15]  Christian Lovis,et al.  White Paper: Patient-centered Applications: Use of Information Technology to Promote Disease Management and Wellness. A White Paper by the AMIA Knowledge in Motion Working Group , 2008, J. Am. Medical Informatics Assoc..

[16]  Chen-Tan Lin,et al.  Review Paper: The Effects of Promoting Patient Access to Medical Records: A Review , 2003, J. Am. Medical Informatics Assoc..

[17]  Tejal K. Gandhi,et al.  Clinicians Recognize Value of Patient Review of their Electronic Health Record Data , 2006, AMIA.

[18]  C. H. C. Drossaert,et al.  Experiences and Preferences of Patients with Rheumatic Diseases Regarding an Interactive Health Communication Application , 2010, 2010 Second International Conference on eHealth, Telemedicine, and Social Medicine.

[19]  Chen-Tan Lin,et al.  Research Paper: Use of a Patient-Accessible Electronic Medical Record in a Practice for Congestive Heart Failure: Patient and Physician Experiences , 2004, J. Am. Medical Informatics Assoc..

[20]  M. Adler,et al.  Gazing into the oracle : the Delphi method and its application to social policy and public health , 1996 .

[21]  W. N. Dunn,et al.  Public Policy Analysis: An Integrated Approach , 2017 .

[22]  Murray Turoff,et al.  The Delphi Method: Techniques and Applications , 1976 .