Most U.S. Doctors Would Limit Patient EHR Access

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Most U.S. doctors are willing to let patients update their electronic health records, but only 31% are willing to give patients full online access to their medical records, according to a recent Accenture survey of physicians in eight countries. Of the U.S. respondents, 65% said patients should have limited access to their records and 4% said they'd bar patients from having any online access.

Accenture surveyed 3,700 doctors in Australia, Canada, England, France, Germany, Singapore, Spain and the U.S. While the results were broadly similar across countries, American doctors were the most inclined to letting patients update their records.

Most U.S. respondents agreed that patients should be able to update demographics, family medical histories, allergies and medications. Four of five U.S. doctors also believed that patients should be able to add some clinical updates to their records, including new symptoms and self-measured metrics such as blood pressure and glucose levels. However, nearly half of the U.S. respondents said patients should not be able to update their lab results.

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Doctors would like patients to be able to "audit but not erase" anything in the record, noted Kaveh Safavi, managing director, North American Health, for Accenture, in an interview with InformationWeek Healthcare.

Perhaps as a result, between 21% and 36% of U.S. physicians said that in categories other than demographics, patients should be able to update only some information. For example, 31% favored letting patients enter only some changes in symptoms; 27% would let them add only some new medications; and 32% would allow updates on just certain medication side effects.

The survey results also point to a disconnect between what doctors say they believe and what they do. Nearly half of surveyed physicians said that giving patients access to their records is crucial to providing more effective care. But only 21% of respondents currently allow patients to have online access to a summary of care or their patient chart. Although the report didn't say so, some physicians who want to give people access to their records might not be using patient Web portals.

The key takeaway from the survey, in Safavi's view, is that physicians are becoming more open to the idea of patients adding information to their records. "We're getting close to the point where half of the doctors are comfortable with patient-entered data. That creates a critical mass [that could lead to innovations]," he said.

It also bodes well for part of the Health IT Policy Committee's proposal on Meaningful Use stage 3 requirements. One proposed item, for example, would require providers to give 10% of their patients the ability to submit patient-generated health information to improve their performance in treating high-priority health conditions.

Safavi observed that some physicians may feel better about having patients add information to their charts after they've experienced it. He cited a recent Harvard Medical School study showing that the majority of patients read progress notes when their doctors made them available online. Many patients said that it improved their medication adherence and their overall control of their own healthcare. Four of five doctors in the three-site study were enthusiastic about note-sharing at the end of the yearlong study, including some who'd been skeptical about it at the outset.

In a press release, Mark Knickrehm, global managing director of Accenture Health, said, "Many physicians believe that patients should take an active role in managing their own health information, because it fosters personal responsibility and ownership and enables both the patient and the doctor to track progress outside scheduled appointments. Several U.S. health systems have proven that the benefits outweigh the risks in allowing patients open access to their health records, and we expect this trend to continue."