Electronic Health Records

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Patients with PHR access more responsible, engaged, satisfied

By Jennifer Bresnick

- Providers who are worried about meeting the Stage 2 Meaningful Use patient engagement guidelines may be able to rest easier at night after reading the results of several recent studies showing just how enthusiastic patients are about accessing their personal health records (PHR).  Gone are the days of physician being sole arbiter of the clinical note: patients want to see what their providers are saying, and those who have the ability to do so are more informed, more engaged, and more positive about their healthcare and their lifestyle decisions.

A new study published in the Journal of Medical Internet Research shows that patients in the Veterans Affairs healthcare system are overwhelmingly positive about access to their personal health information, despite provider concerns that reading through a long list of test result numbers and clinical jargon with no explanation might be confusing or off-putting.  Patients reported being able to ask more informed questions after reviewing their results before a consult, feeling less stressed trying to remember what their providers had told them during an appointment, and being more likely to recall a follow up appointment when the information was accessible from a web portal.

“Doctors aren’t real gabby and they never tell you everything,” said one participant in a focus group. “Even if you ask questions, they’ll sort of slide around them.  They don’t have the time, you know.  I found stuff out that I was just amazed at, truly, about myself.”  Other participants noted that seeing what their doctors were saying about them was a wake-up call that prompted more responsibility and better everyday choices.  “I found the cholesterol and all that other stuff, and it made me start thinking about my lifestyle and how I needed to do a little bit more on my own and not depend on the doctor to hand me pills and stuff,” one patient acknowledged. “It encouraged me.  I knew more. I understood more.”

The VA’s patient portal, HealtheVet, was modified for the study to allow access to test results, lab reports, clinical and discharge notes, and vital signs.  Patients who reviewed this data made an effort to research medical information and figure out unknown terminology using the internet without having to ask a doctor or nurse in person, which some patients might be hesitant to do.

Online access also helped patients sift through everything their physician might have told them at their leisure, reducing the stress and agitation of having to memorize a slew of numbers and diagnoses before they leave the office.  “If they tell you something you don’t understand or you forget, because maybe it’s bad news or something, you go home and you really don’t remember. Somebody will say, ‘What did they tell you?’ Well, I don’t know, but if you go on HealtheVet, you can find it,” a patient added.

“Just knowing is better than not knowing, I think, in most things in life,” another participant said. “Because you can imagine a lot of stuff in your health world.  Is this a pimple or am I dying of cancer? You go through that whole thing.  So, just knowing, just being able to review that and say, ‘Okay, I’m not dying of cancer. That’s a pimple,’ gave me peace of mind.”




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