Notes & Links: August 26, 2013

Consumers’Perceptions of Patient-Accessible Electronic Medical Records
Zarcadoolas, Vaughon, et. al publishing in JMIR completed a qualitative study to to identify vulnerable consumers response to patient portals and how they perceived the value and utility. 

The authors do an excellent job of defining an electronic health tool and patient portal with the bottom line being “allowing consumers to take greater control of their health information by changing traditional top-down (doctor to patient) methods of health communication and improving satisfaction with provider communications and overall care”. This is the outcome we’ve all been seeking in healthcare. 

The authors take care to clearly establish how consumers are more and more interested in accessing their personal health information online and reference a Markle Survey on Health in A Networked Life reports that nearly 70% of the publish and 65% of physicians believe patient should be able to access and retain their health records. In addition the authors note and examine the fact their is a vulnerability of certain populations to disparities in health outcomes and quality care. These groups being poor, immigrants, and lacking English proficiency. 

The authors examined participants record-keeping behaviors, sources of health information and initial response to the idea of patient portals. The Key Themes that emerged from this study were:

  • Consumer/Patient Empowerment-“Information is Power”
  • Extending the Doctor’s Visit/Enhancing Communication with HCP
  • Literacy and Health Literacy (The authors capture critical information that will drive these results)
  • Prevention and Health Maintenance
  • Privacy and Security Concerns
  • Response to the Concept of Patient Portals with More Information: Post Demonstration

Conclusion 
The intent and promise of patient portals is that they will help engage people with their health, improve preventive care behaviors, and permit better management of chronic conditions. A handful of recent studies have begun to examine patients’ uptake of portals as well as patients’ perceptions and assessments of their actual use. Consistent with the views of our study participants, users report finding great value in patient portals [73], a perception shared by a wide range of patients, including those with mental health and substance abuse issues [68] as well as patients with HIV [67]. In general, patients report that portals positively impact communication with providers, and improved knowledge, empowerment, and self-care.

This is a great study and will help those of us looking to improve and expand patients involved in their healthcare and their engagement with their HCP. Another paper to print read and save. Their conclusions are more extensive and deserve to read and considered. 

Why Doctors Should Stay Out of The Business of Building EHRs
Fred Trotter writing on The Health Care Blog addresses the fact many physicians are ‘writing their EHR’ from scratch and how they have to step away from the screen and leave it to the professionals. His primary argument is that we need to have these tools built by those who know how. 

A doctor developing a new EHR system from scratch, by themselves, without extensive Health IT programming experience is in over their head. If they continue to develop an EHR, even after being warned of the dangers here, then this is hubris.

Ask yourself: Are you absolutely sure that this action is not a fundamental violation of the oath that you took when you became a doctor?

I would take it a step further and consider the article above from JMIR on how a well developed and crafted EMR along with a patient portal can change care and the patient physician engagement model. This further speaks to the need for educators and communicators to build and drive EMR.

By the way the comments are one big pissing battle which should not be confused with the need to use EMRs to drive engagement, patient care, learning, and outcomes.  

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