J. Med. Internet Res. - Patient experiences with full electronic access to health records and clinical notes through the My HealtheVet Personal Health Record Pilot: qualitative study.

Tópicos

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Resumo

CKGROUND: Full sharing of the electronic health record with patients has been identified as an important opportunity to engage patients in their health and health care. The My HealtheVet Pilot, the initial personal health record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic health record, including clinical notes, laboratory tests, and imaging reports.OBJECTIVE: A qualitative study with purposeful sampling sought to examine patients' views and experiences with reading their health records, including their clinical notes, online.METHODS: Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic health records participated in the sessions.RESULTS: Four themes characterized patient experiences with reading the full complement of their health information. Patients felt that seeing their records positively affected communication with providers and the health system, enhanced knowledge of their health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their health record information provided benefits.CONCLUSIONS: Patients and their delegates had predominantly positive experiences with health record transparency and the open sharing of notes and test results. Viewing their records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full record access on patient well-being. While shared records may or may not impact overall clinic workload, it is likely to change providers' work, necessitating new types of skills to communicate and partner with patients.

Resumo Limpo

ckground full share electron health record patient identifi import opportun engag patient health health care healthevet pilot initi person health record us depart veteran affair allow patient deleg view download content electron health record includ clinic note laboratori test imag reportsobject qualit studi purpos sampl sought examin patient view experi read health record includ clinic note onlinemethod five focus group session conduct patient famili member enrol healthevet pilot portland veteran administr medic center oregon total patient enrol healthevet pilot famili member access view electron health record particip sessionsresult four theme character patient experi read full complement health inform patient felt see record posit affect communic provid health system enhanc knowledg health improv selfcar allow greater particip qualiti care followup abnorm test result decisionmak seek care patient felt see previous undisclos inform derogatori languag inconsist note caus challeng overwhelm felt rather less health record inform provid benefitsconclus patient deleg predomin posit experi health record transpar open share note test result view record appear empow patient enhanc contribut care call question common provid concern effect full record access patient wellb share record may may impact overal clinic workload like chang provid work necessit new type skill communic partner patient

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