Physicians And Patients At Odds Over Patient Access To EHRs

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Two-thirds of doctors want limited patient access; 4% want no patient access at all

Practice Fusion announced Monday the launch of Patient Fusion, a service which allows visitors to find a verified doctor based on specialty and location, read reviews from actual patient visits, and instantly request appointments. Users of Practice Fusion's free electronic health record (EHR) system also have instant access to their personal health records online.

Ryan Howard, CEO of Practice Fusion, said users of Patient Fusion will have “the power to access and control” their own health records. More than 27,000 doctors in the United States are using Practice Fusion's EHR and the company says that “By granting patients access to their records, practices can make it easier for patients to keep an eye on key data such as immunizations and allergies and to follow post-visit instructions.”

But, despite the offerings of Practice Fusion and other companies like them, not all doctors are ready to share their electronic records.

Bloomberg Businessweek notes that, “As the use of electronic health records spreads, most doctors say they want strict controls placed on patients’ access to their digital medical records.” They refer to this study by Accenture which shows “68 percent of U.S. doctors do not want patients to have full access to their electronic health records” and “restrictions they want vary, from not wanting patients to edit their records … to a minority (4 percent) who do not want patients to see their records in digital form at all.”

The Bloomberg article also points out “Doctors’ preference for these restrictions compromises one of the most attractive things about electronic records: the ability for patients to be able to access their complete medical record in an instant, which could be vital in a medical emergency if they are being treated by doctor who otherwise wouldn’t know their history.”

The doctors want for limited access at best could be hurting the patient, however. PhysBizTech reports a study published in the Journal of Medical Internet Research which sums up its findings as follows:

• patients reported that seeing their records had a positive effect on care communication between visits as well as during encounters
• access was felt to improve patients’ knowledge about their own health and prompted greater desire for self-care
• patients reported that health record access improved participation in their care in a variety of ways

InformationWeek, referring to the same Journal of Medical Internet Research study, saysc “Common provider concerns about giving patients full access to their records appeared unwarranted.” They go on to say that doctor's worries that giving patients full access to records will cause distress and confusion among patients and increase work for office staff are misplaced, writing ,“The first concern is likely overblown.” As for the second – increasing office staff workload – they write, “Record sharing can actually decrease workload by reducing phone calls to clinics and requests for record copying.”

Electronic Health Reporter, while acknowledging both sides of the conflict, writes “though there may be initial resistance, like all cultures built to change, what was once unacceptable will become standard practice.” Health Clare Global echoes that sentiment, reporting the Journal of Medical Internet Research study shows 53% of doctors “believe that electronic health records have improved the quality of patient care. And 83% are under the opinion that within the next two years, electronic records will become integral to providing effective patient care.”