The use of electronic health records (EHRs) is now standard operating procedure in many medical practices, but access to them is a bone of contention. While many patients want to be able to read and add to their records, doctors may not be comfortable with this.
An online survey of over 9,000 people conducted by Accenture to assess consumer perceptions of their medical providers’ electronic capabilities found that about 84% of patients believed they should have full access to their EHRs, while only 36% of doctors shared this belief. In fact, 65% of U.S. doctors said patients should have only limited access to their records. This is what most patients (63%) say they currently have.
Why this reluctance to share on the part of doctors? The survey found that doctors’ concerns over patient access to EHRs really center on issues of accuracy. When several people can access and edit a file, it increases the chance of confusing or inaccurate information being entered in a patient’s record.
Most doctors say they are willing to have patients make minor changes to their records, such as updating their family medical history (88%) or allergies (85%). These are details that patients routinely fill out when they visit the doctor’s office.
On the other hand, the majority of doctors did not want patients editing their own records with details on lab test results, new symptoms they experience, or medications they’ve been prescribed. Their concern is that a patient may incorrectly enter the name of a medication or put a decimal in the wrong place on a test result.
On the plus side, EHRs can be used to foster patient engagement, especially when patients can access notes from their office visit. Patients often retain very little of what’s discussed in the doctor’s office, so being able to go home and look up the notes from their visit presents a real opportunity for education and involvement.
A recent study by researchers at Harvard Medical School found that when doctors let patients view their progress notes—the part of the medical record doctors were most reluctant to share—patients' compliance with medications increased.
The one-year study involved 105 primary care physicians from medical centers in Massachusetts, Pennsylvania, and Washington. After the doctors entered visit notes into patients’ EHRs, patients were invited via email to read the notes on their respective patient portals.
Of the over 13,000 patients who participated, nearly 90% viewed one or more notes. In a post-intervention survey (completed by about 6,000 patients), 77-87% of patients reported that having access to the notes helped them feel more in control of their care. Of those taking medications, 60-78% reported increased medication adherence. Ninety-nine percent of patients said they wanted to continue to have access to their notes after the study.
Interestingly, at the end of the study, 70% of physicians said that note sharing had strengthened their relationship with patients and improved patient satisfaction, patient safety, and patient education.
As healthcare educators, we believe that giving patients access to their medical record and letting them interact with it instead of just carrying it from one doctor’s office to another opens the door to engagement and a more collaborative patient-provider relationship. We encourage doctors to introduce patients to their EHRs and discuss how to use them to update their health information and strengthen their understanding of their medical conditions and treatment.