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9/17/2013
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Patients Seek More Online Access To Medical Records

41% of those who don't have online access to records would consider switching physicians to obtain it, Accenture survey finds.

Kaveh Safavi, MD, managing director, North America Health, for Accenture, told InformationWeek that he isn't surprised by the implication that online record sharing is more important to many patients than a doctor's knowledge and skill. "If a patient has a very serious condition, they might want to go to a world expert and may not want to go anywhere else," he said. "But if I want to have a relationship with a pediatrician for my kids for 18 years, this [online access to records] may matter a lot to me."

Why would older people, many of whom have serious chronic conditions, place such a strong emphasis on record sharing? "One could suggest that if I have a chronic condition, I'd be more invested in caring for myself and need to have more of the information than if I have an acute condition," Safavi replied. "So people with chronic conditions might care more" about online access to their records.

Access to records tops the list of what consumers want online, he said, partly because of the similar services they already receive from other industries. "Patients are aware of the concept of us having access to our information. Think about financial services. It's our money. And this is our medical record. One might expect that consumers would have the same expectation of healthcare as they do from other services: 'It's my information, can I see it?'"

In addition, the Accenture report pointed out, many consumers now keep track of information about their own health. Consumers most commonly track their health history (37%), followed by their physical activity or diet (34%) and health indicators such as weight and blood pressure (33%). Being able to view their clinical records is a natural complement to that activity.

Nearly all doctors (96%) and consumers (98%) say that patients should be able to access their electronic health records. But while 84% of consumers want full access to those records, 65% of doctors say patients should have limited access. In addition, 81% of patients say they should be allowed to update their records.

A recent study by researchers at Harvard Medical School found that when physicians let patients view their progress notes -- the part of the record they were most reluctant to share -- patients' compliance with prescribed medications grew. Moreover, the doctors' earlier fears that note sharing would increase their workload and confuse patients proved unfounded.

"That was very interesting, because the doctors who were reticent [to share their progress notes], once they engaged in it, they realized it wasn't so bad and they actually liked it a lot," Savafi commented. "But there was a lot of resistance before they decided to try it." Noting that Meaningful Use stage 2 requires physicians to share records with patients, he said that this part of the government EHR incentive program reflects as well as encourages the changes going on in the doctor-patient relationship.

"The traditional concept of the medical record was it was something the doctor had, and the patient's only role was to carry it around from one place to another," he explained. "When the patient can view the record, interact it, and potentially add things to it, this is a real platform for a shared relationship."

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Alex Kane Rudansky
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Alex Kane Rudansky,
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9/24/2013 | 3:44:38 PM
re: Patients Seek More Online Access To Medical Records
Also important to consider the disparities in those using patient portals/ accessing EMRs and which patients are actually embracing this access -- and if they have access at all.

A 2010 study conducted in New York City published in the Journal of General Internal Medicine reported that 16% of all patients in the study received an access code to a patient portal, and of these, 60% activated their code. Those who activated their access tended to be whiter, English-speakers, and with private insurance.

How can providers expand access?
Alex Kane Rudansky
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Alex Kane Rudansky,
User Rank: Author
9/24/2013 | 3:33:44 PM
re: Patients Seek More Online Access To Medical Records
This plays into the overarching theme of patient engagement-- when you give patients access to their records and make things like refilling prescriptions as easy as a mouse click, you get more patient interest and better patient outcomes. Still, I don't believe that this is a replacement for face-to-face or phone communication. There is a certain value in that type of relationship that can't be replicated online.
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