Patients worried about medical records going digital

It took some time to get a majority of physicians in the U.S. to agree that it would be beneficial to implement electronic health records in their practices. Now, a survey finds, the most skeptical audience for EHRs is patients.

A survey of more than 2,100 patients by Xerox found that only 26% want their medical records to be digital, down two percentage points from a year ago. Only 40% believe EHRs will result in better, more efficient care. And 85% expressed concern about digital records. Their main worries: privacy and security of their information.

When asked what, specifically, worries them about EHRs, respondents said they were concerned that their information could be stolen by a hacker (63%), the files could be lost, damaged or corrupted (50%), their personal information could be misused (51%), or a power outage or computer problem could prevent doctors from accessing their information (50%). Fifteen percent said they had no worries.

There are many things in medicine that patients tolerate but don’t necessarily like. If most physicians will be electronic soon anyway, some physicians may wonder why it’s important to convince their patients that EHRs are a good thing instead of just letting them learn to live with them.

As the health care system shifts from one that focuses on acute care and treating patients who are sick to one that promotes wellness, “We need the patients as active participants,” said Philip Payne, PhD, chair of the Ohio State University College of Medicine’s Dept. of Biomedical Informatics. The EHR is an important tool to engage patients, he said.

Despite the benefits an EHR might bring, major data breaches are announced on virtually a weekly basis. For example, in the summer of 2012, a computer containing the medical information of 2,500 patients from the Stanford (Calif.) Hospital & Clinics and the School of Medicine was reported stolen. In Connecticut, information on more than 7,461 VNA Healthcare patients and 2,097 Hartford Hospital patients was lost when a computer belonging to a data analysis vendor was stolen. Beth Israel Deaconess Medical Center in Boston announced that the health information of 3,900 patients was put at risk when a physician’s personal laptop was stolen.

How to give assurance

The main message physicians should be spreading to patients who are concerned about breaches is that “people do bad things, whether it’s in paper form or electronic form,” said Mary Griskewicz, senior director of ambulatory health information systems for the Healthcare Information and Management Systems Society.

Michael Hobaugh, MD, PhD, chief of medical staff at La Rabida Children’s Hospital in Chicago, said if patients express concerns about data safety, physicians can tell them that there are many safety features of an EHR that patients never had with paper.

“The biggest assurance that patients have regarding electronic medical records is that anytime anybody looks at something or prints something, there is a record of who did it,” Dr. Hobaugh said. “That was not true of paper charts.”

Christine Bechtel, vice president of the National Partnership for Women and Families, said a survey her organization conducted, similar to the one by Xerox, found respondents rating EHRs higher than paper across the board in various safety and quality measures. She said the survey, released in February, shows that even if patients worry about their own information, many are showing confidence in EHRs in general.

Griskewicz said physicians need to be educated on how and when to engage consumers when it comes to technology adoption. HIMSS launched the HIMSS eConnecting with Consumers Committee this year, whose focus is to provide physicians with tools and education surrounding patient engagement and technology.

Many patient concerns stem from the fact that the value of EHRs has not been made clear to patients, Payne said.

“We really have to figure out how we make the EHR a focal point of collaboration between patients and members of multidisciplinary care teams rather than just a thing that’s in the room that we have to use to document so we can bill,” he said.