Do you check your medical record online? A new study says that most people don’t (Health Affairs, online Nov. 4, 2019). Healthcare facilities such as hospitals and clinics have been offered financial incentives to adopt electronic health records and to offer patients access. By reviewing their electronic records, patients are supposed to become better informed and more engaged in their healthcare.
Are People Reviewing Their Electronic Health Record?
The researchers asking that question analyzed data from more than 2,000 hospitals around the country between 2014 and 2016. The vast majority of people discharged from these institutions–95%–were offered a way to view, download and share their electronic health information.
The envelope please: Only one out of ten people with such access took advantage of it. That is abysmal. Why don’t people read their electronic health record?
Some Obvious Reasons:
The investigative team found some unsurprising patterns. People without computers or Internet access at home were very unlikely to log in to their patient portals. Also, hospitals with a large proportion of low-income patients saw much lower rates of patient access than average. This has been referred to as the digital divide.
The study did not determine whether people utilizing their digital records access had better health outcomes.
However, the analysts concluded:
“Policy makers seeking to improve patient-centered care should therefore consider efforts to reduce this persistent digital divide by targeting both hospital- and patient-facing determinants of electronic health information access and use.”
What Is in the Electronic Health Record?
We have talked to a lot of health experts about online access to medical records. We were very active in helping Duke University Health System plan its initial electronic health record system. We had high hopes.
Sadly, when the electronic health systems were rolled out around the country, the bean counters were firmly in control. They were very excited about creating ways for patients to pay their bills online. They were also thrilled to encourage patients to schedule appointments electronically. Test results were included in the system along with messaging systems that allow patients to ask a provider about lab tests and prescription renewals.
The Missing Information!
What you will not see in many electronic health records is the actual electronic health record of the patient. These are often referred to as “clinic notes.” Some of these systems permit a brief summary of the health condition, but rarely do patients see what is in their full medical record, especially the clinic notes.
The few hospitals that have adopted such a system call it “Open Notes.” This represents the nuts and bolts of each patient’s electronic health record. This is what the health provider thinks is going on. There is also likely to be a care plan.
When an Open Note system is adopted, doctors like it and patients like it. Despite its enthusiastic reception, most clinics and hospital systems are reluctant to provide this kind of inside information to patients. We don’t know what they are afraid of.
You can read more about Open Notes at this link:
Would You Read Your Electronic Health Record?
If you could see your clinic notes in understandable language would you visit your electronic health record more frequently? Would you take the time to correct any mistakes? (By the way, they are surprisingly common.)
We would love to know whether an Open Note system is something you care about or whether you find this whole conversation boring. Please let us know in the comment section below.