Patients recognize quality and security benefits of EMRs
■ A practical look at information technology issues and usage
Patients believe physicians' use of electronic medical records can help improve the quality of care they receive. And if a physician offers patients access to the EMR, they feel confident the doctor will protect the privacy of their health information.
A survey commissioned by the National Partnership for Women & Families looked at how consumers value and trust health information technology. It found that patients see value in EMR systems regardless of whether their physicians use them.
Nearly 2,000 patients of primary care physicians participated in the online survey, which was conducted by Harris Interactive in August 2011. Of those, 58.8% said their doctor uses an EMR, and 41.2% said their physician primarily uses paper records. An oversampling of Hispanics was conducted to see how their attitudes differed from the general population.
The survey was the first that measured consumer perceptions and experiences with EMRs and paper records, said Christine Bechtel, vice president of the National Partnership for Women & Families. Besides the high level of confidence that EMRs improved quality, another key finding was that patients trust physicians to protect their rights. That trust increases if the doctor uses an EMR. And the more access the patient has to his or her records, the more they value and trust EMRs.
The study was important because "it looked at reality versus theory in terms of using these systems," said Ted Eytan, MD, a family physician and director of the Permanente Federation at Kaiser Permanente.
Patients were asked whether an EMR is or would be useful for seven key elements of care, including issues such as communication with the physician and ensuring the doctor has timely access to relevant information. The EMR's usefulness in those areas ranged from 88% to 97% of those whose doctor uses an EMR and 80% to 97% of those whose physician uses paper records. Six percent of respondents whose doctors use an EMR were dissatisfied with the EMR.
However, concerns about data breaches and privacy laws are high among both groups. Fifty-one percent of the EMR group somewhat or strongly agreed that federal and state laws and organizational practices are not doing enough to protect the privacy of medical records and health information. Of the paper group, 53% somewhat or strongly agreed. When asked whether widespread adoption of EMRs would lead to even more personal information being lost or stolen, 59% of the EMR group somewhat or strongly agreed, and 66% of the paper group somewhat or strongly agreed.
Hispanics were more likely than the general population to believe EMR adoption would increase data breaches, with 73% saying so, compared with 59% of the total population.
The report recommends that physicians, nurses and other clinicians play key roles in engaging consumers with information about privacy and value in health IT.
Physicians are trusted to a very high degree, Bechtel said. "More than 90% of survey respondents said they trusted their doctors when it came to protecting the privacy of their health information, so I think they can and should play a really valuable role ... in talking with patients about electronic medical records."
Farzad Mostashari, MD, national coordinator for health information technology, said federally funded regional extension centers can play a valuable role in teaching physicians how best to disseminate this information to patients.
The report also found that physicians can help increase patient trust by providing patients with more online access to their records.
Sixty-seven percent of patients with online access to records said they felt well-informed by their physician and staff on how their medical information is collected and used, compared with 51% of paper record patients who felt well-informed. Patients whose doctors had EMRs also believed they were better informed than their paper-based counterparts on their right to exercise choice before their records are shared with others outside health care. The difference was 62% of the EMR group compared with 52% of the paper group.
The report also recommends that stages 2 and 3 of meaningful use criteria under Medicare and Medicaid include efforts to support improved patient perception of value and trust in health IT. Examples include care coordination, online access to records, secure messaging with physicians and the ability of patients to contribute data and information to their records.
Dr. Eytan said the study is fueling a change of attitude that EMRs are for doctors, and personal health records are for patients.
"I think now we are understanding -- and I have always believed this -- that the electronic health record is for patients and doctors, and the huge change that this makes is that when these systems are designed, implemented and used, they are used with the idea that patients and doctors can understand everything in them and are usable for both."