Doctors skeptical of personal health records

A survey of more than 800 physicians across multiple specialties found that many doctors are willing to use personal health records in their practices, despite their skepticism of the benefits.

For purposes of the survey, published in the February issue of Health Affairs, PHRs were defined as both medical record systems controlled by patients and patient portals that give patients access to their physicians' records. Physician use of PHRs included offering them to patients, contributing information to a patient-run PHR, and using the data in a patient's PHR for clinical care.

The survey found that 64% of physicians had never used PHRs and that 42% were willing to do so. Twenty-four percent of doctors surveyed said they are unwilling to use them. Fourteen percent said they are frequent users of PHRs (link).

Of those physicians willing to incorporate PHRs into their practices, just fewer than half believed the tools would save time, improve relationships with patients and provide valuable checks of the records for accuracies. Frequent users expressed similar concerns, with 49% saying they save time, 53% saying they improve relationships with patients and only 27% saying they help provide accuracy checks.

One of the study's authors is Matthew Wynia, MD, an infectious disease physician and the director of the American Medical Association's Institute for Ethics. He said that although physicians remain skeptical of some benefits to PHR use, frequent users were more convinced about potential benefits than those unwilling to try them. Physicians also showed less concern for potential downsides.

For example, 56% of experienced users agreed that PHRs help improve the quality of care, compared with 34% of those unwilling to try them. Forty-four percent of those unwilling to use PHRs said they would censor their notes if they knew that patients would see what they write. But only 20% of frequent users say that's the case.

The survey was conducted in 2008 and 2009. Since then, the federal government has implemented financial incentives for meaningful use of electronic medical records. To qualify for those incentives, physicians must use a certified EMR that gives patients access to their test results and lists of medical problems, medications and allergies. The authors expect that by giving patients access to this information, the market for PHRs will expand.

Looking at the concerns and benefits of those who use the technology can help guide policymakers about PHR use, Dr. Wynia said. And, he added, physicians can better understand the changes needed in work flow for doctors to get the most benefit from PHRs.