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Cited by 122Electronic Health Records SystemsHealth Literacy and Information AccessibilityPatient-Provider Communication in Healthcare

Expectations of Patients and Physicians Regarding Patient-Accessible Medical Records

Open access
Ross, Stephen E, Todd, Jamie, Moore, Laurie A, Beaty, Brenda L, Wittevrongel, Loretta, Lin, Chen-Tan·2005·Journal of Medical Internet Research
DOI 10.2196/jmir.7.2.e13PMC PMC1550642
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Abstract

BACKGROUND: Middle class populations have supported shared medical records, including Internet-accessible medical records. The attitudes of lower income populations, and of physicians, are less clear. OBJECTIVES: The objective of this study was to compare the attitudes toward shared outpatient medical records among (1) socioeconomically disadvantaged patients in community health centers, (2) insured patients in primary care offices, and (3) a broad range of physicians in outpatient practice. METHODS: Written questionnaires were provided to patients in the waiting rooms of six primary care practices in the metropolitan Denver, Colorado area. Three practices were community health centers, and three practices were primary care clinics of an academic medical center. Questionnaires were also mailed to primary care physicians in the state of Colorado. RESULTS: There was a 79% response rate for patient surveys (601 surveys returned) and a 53% response rate for physician surveys (564 surveys returned). Academic medical center patients and community health center patients were equally likely to endorse shared medical records (94% vs 96%) and Internet-accessible records (54% vs 57%). Community health center patients were more likely than academic medical center patients to anticipate the benefits of shared medical records (mean number of expected benefits = 7.9 vs 7.1, P < .001), and they were also somewhat more likely to anticipate problems with shared records. Significant predictors of patient endorsement of Internet-accessible records were previous use of the Internet (OR = 2.45, CI 1.59-3.79), the number of expected benefits (OR = 1.12 per unit, CI 1.03-1.21), anticipation of asking more questions between visits (OR = 1.73, CI 1.18-2.54), and anticipation of finding the doctors' notes to be confusing (OR = 1.50, CI 1.01-2.22). Physicians were significantly more likely than patients to anticipate that access to records would cause problems. Physicians were significantly less likely than patients to anticipate benefits (mean number of expected benefits = 4.2 vs 7.5, P < .001). CONCLUSIONS: Interest in shared medical records is not confined to a white, middle class population. Shared medical records are almost universally endorsed across a broad range of ethnic and socioeconomic groups. A majority of patients are also interested in Internet-accessible records, but a substantial minority is not. The primary determinants of support of Internet-accessible records are not age, race, or education level; rather, they are previous experience with the Internet and patients' expectations of the benefits and drawbacks of reading their medical records. Physicians have more concerns about shared medical records and see less potential for benefit. The attitudes of patients and physicians may need to be reconciled for widespread adoption of shared medial records to be achieved.

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  • In a 2005 U.S. survey of patients and physicians, patients in both settings were equally likely to endorse shared medical records (94% vs 96%).

    “Patients in both settings were ''equally likely to endorse shared medical records (94% vs. 96%).''”

    From The Empirical Foundations of Telemedicine Interventions in Primary Care (2016) · cites this paper as [44]

  • In that survey, patients in community health centers were somewhat more likely to anticipate problems with shared records.

    “However, patients in community health centers were more sanguine about ''. the benefits of shared medical records'' (measured in terms of number of benefits: 7.9 vs. 7.1) and ''.somewhat more likely to anticipate problems with shared records.''”

    From The Empirical Foundations of Telemedicine Interventions in Primary Care (2016) · cites this paper as [44]

  • In that survey, patients in community health centers reported more benefits of shared medical records than patients in academic medical center clinics (7.9 vs 7.1).

    “However, patients in community health centers were more sanguine about ''. the benefits of shared medical records'' (measured in terms of number of benefits: 7.9 vs. 7.1) and ''.somewhat more likely to anticipate problems with shared records.''”

    From The Empirical Foundations of Telemedicine Interventions in Primary Care (2016) · cites this paper as [44]

  • In that survey, physicians were more likely than patients to believe that patient access to records would cause problems and less likely to anticipate benefits for patients.

    “On the other hand, physicians were more likely than patients to believe that patient access to records would cause problems and less likely to anticipate benefits for the patients.”

    From The Empirical Foundations of Telemedicine Interventions in Primary Care (2016) · cites this paper as [44]

  • The key finding in this survey is that patients' positive expectations regarding the benefits of shared records were not matched by those of their physicians.

    “The key finding in this survey is that patients' positive expectations regarding the benefits of shared records were not matched by those of their physicians.”

    From The Empirical Foundations of Telemedicine Interventions in Primary Care (2016) · cites this paper as [44]

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Authors
Ross, S. E., Todd, J., Moore, L. A., Beaty, B. L., Wittevrongel, L., & Lin, C.-T.
Affiliations
University of Colorado Health (US)
Corresponding author
Ross, Stephen E
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2005-05-24
Volume
7
Issue
2
Pages
e13
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.7.2.e13
PMC
PMC1550642
OpenAlex
W2111725487
Cited by
122
References
15
Citations by year
2025: 4 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 7 · 2020: 3 · 2019: 7 · 2018: 6 · 2017: 8 · 2016: 9 · 2015: 10 · 2014: 11 · 2013: 12 · 2012: 6
FWCI
14.08
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Commonwealth Fund
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
shared medical records, patient attitudes, physician attitudes, socioeconomic status, community health centers, primary care, patient expectations, health information technology adoption, patient-physician communication, health disparities, Denver, community health center patients, primary care physicians
MeSH terms
Adult, Aged, Attitude, Attitude of Health Personnel, Ethnicity, Female, Humans, Male, Middle Aged, Patients, Physicians, Surveys and Questionnaires, Social Class, Internet, Patient Access to Records

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