According to a new Harris Poll survey, conducted on behalf of the management consulting firm Accenture, less than one-third of U.S. doctors think patients should have full access to their own electronic health records.
As a patient, you may literally trust your doctor with your life, and the doctor-patient relationship relies on this level of trust. The relationship should be one of give and take, even if the exchange is sometimes dominated by the professional.
So it may come as a surprise that 65 percent of docs believe their patients should have only limited access to their electronic health records, and 4 percent believe patients should have no access at all.
One thing is clear — patients believe electronic medical records improve their care. According to a 2011 survey, conducted by GfK Roper on behalf of Practice Fusion, a San Francisco-based electronic health record provider, 78 percent of patients whose doctors kept electronic medical records felt that their care improved.
“Patients want their healthcare to reflect the fact we’re in the 21st century,” said Ryan Howard, CEO of Practice Fusion. “They want to have prescriptions sent electronically, to receive email appointment reminders and to review past diagnoses and upcoming appointments online.”
“Several US health systems have proven that the benefits outweigh the risks in allowing patients open access to their medical records, and we expect this trend to continue,” said Mark Knicrehm, senior global managing director of Accenture Health, of the poll’s results.
While a majority of doctors in the Accenture survey wouldn’t trust patients with full access to their records, 81 percent said they wanted their patients to keep the records up to date, which may seem like a disconnect.
Primarily, though, the doctors are referring to updating personal information, not medical information. Almost all doctors polled think patients should update their own demographic information (95 percent), family history (88 percent), medications (86 percent), allergies (85 percent), and even some medical information, like new symptoms and self-administered test results (81 percent).
There seem to be few disadvantages to giving patients access to records and some real advantages, according to experts and commentators. So why do many doctors feel that their patients should not have full access to their electronic medical records?
Stephen Baker, author of The Numerati blog, wrote that patient sensitivity may be to blame for doctors’ unwillingness to share medical records.
“This would not be a problem if we, as a society, weren’t so hypersensitive to ‘hurtful’ words, and eager to sue in cases of errors,” Baker stated on his blog.
He used an example of a doctor speculating about his or her patient being the victim of abuse. While the patient might be offended on reading this information in their electronic medical record, the doctor might feel that it’s important to document their observations. Baker concluded, “if we want the data, we should be ready to see and accept it, even when offensive. This openness would pay off richly.”
Thomas J. Vento, MD, a family doctor in private practice in Reisterstown, Md., sees the benefits of open access to medical records, because patients can help prevent medical errors.
“It’s a great idea to give your family doctor a copy to keep in his file, but it’s also very important to have your own copy of the health journal in case of a medical emergency,” Dr. Vento said. “Being an active voice in health care is an integral part of getting the best care you can for yourself and your children.”
After a 2012 study found that doctors failed to read many test results when patients were discharged from hospitals, experts claimed that electronic records could help “prevent important information from falling through cracks.”
“[This] problem could be solved with electronic medical records that keep track of test results and alert doctors when the results have not been reviewed,” said Gordon Schiff, MD, associate director of the Brigham Center for Patient Safety Research and Practice, at the time. “Patients also can play a role by keeping track of their tests and asking their doctor about the results.”
As doctors and medical institutions continue to switch to electronic medical records, and patients demand more access, the debate will continue: How much information should patients have access to?