Patient experiences with full electronic access to health records and clinical notes through the my healthevet personal health record pilot

Qualitative study

Susan S. Woods, Erin Schwartz, Anais Tuepker, Nancy Press, Kim M. Nazi, Carolyn L. Turvey, W. Paul Nichol

    Research output: Contribution to journalArticle

    124 Citations (Scopus)

    Abstract

    Background: 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.

    Original languageEnglish (US)
    JournalJournal of Medical Internet Research
    Volume15
    Issue number3
    DOIs
    StatePublished - Mar 2013

    Fingerprint

    Personal Health Records
    Health
    Electronic Health Records
    United States Department of Veterans Affairs
    Reading
    Quality of Health Care
    Self Care
    Workload
    Focus Groups

    Keywords

    • EHealth
    • Patient access to records
    • Patient participation
    • Personal health records
    • Veterans

    ASJC Scopus subject areas

    • Health Informatics

    Cite this

    Patient experiences with full electronic access to health records and clinical notes through the my healthevet personal health record pilot : Qualitative study. / Woods, Susan S.; Schwartz, Erin; Tuepker, Anais; Press, Nancy; Nazi, Kim M.; Turvey, Carolyn L.; Nichol, W. Paul.

    In: Journal of Medical Internet Research, Vol. 15, No. 3, 03.2013.

    Research output: Contribution to journalArticle

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    abstract = "Background: 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.",
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