Should Electronic Medical Records Be Shared With Patients?

Although electronic medical records can contribute to larger goals when it comes to epidemiology and public health, many of the arguments for using them come down to simple logistics: EMRs protect patient files from physical destruction, eliminate the concerns about legibility associated with handwritten records (which in turn can lead to medical errors), and result in an overall increase in efficiency of about 6% annually.

But online EMR software, in particular, offers another opportunity that’s far more controversial: sharing notes with patients, generally through secured online portals. Because so many patients ask for such access, and because so many healthcare providers express doubt about providing it, a recent research team decided to track what occurred when providers opened up their medical notes to patients.

The Outcomes

In order to measure the impact of opening up electronic medical records to patients, a team partnered with 105 primary care physicians at three sites. After a patient’s appointment, he or she received a message offering the opportunity to log on and read a note about the visit. Before the patient’s next visit, he or she received another message encouraging a review of the previous note in preparation.

The researchers found that more than 80% of the patients opened at least one note, and that more than two-thirds reported “better understanding of their health and medical conditions, taking better care of themselves, doing better with taking their medications, or feeling more in control of their care.” Very few patients (1% to 8%) expressed feeling worried or confused because of the notes.

The impact on doctors, though relatively minimal, also bears considering. Only 3% said they spent more time answering questions outside of regularly scheduled appointments (and email volume remained the same). About 20% of physicians said that being aware of patient access changed the ways they wrote about obesity, cancer, mental health and substance abuse, and about 11% said they spent more time writing and editing their notes. The full results of the study are available online in the British Medical Journal.

Patient Engagement

Of course, the issue should also be weighed with the big question of all EMR-related work in mind: Does sharing information with patients via web EMRs improve patient outcomes? The recent study’s authors suggest that it might. “Knowledgeable and actively engaged patients may have better outcomes,” a summary of the study’s conclusions reads.

Furthermore, allowing patients to access crucial information in a relaxed home setting — as opposed to the stressful, emotionally charged incidence of a doctor’s appointment or hospital visit — could allow patients to process that information better and become involved in their own healthcare in constructive ways. “We expect fully open records to foster truly collaborative patient-clinician relationships,” the study’s authors write.


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