Study reveals patients' attitudes toward EMR conversion

May 19, 2009 | Molly Merrill, Associate Editor

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Beth Israel Deaconess Medical Center, Boston

BOSTON – A new study suggests that patients are open to having electronic medical records play a more central role in their care.

A research team at Beth Israel Deaconess Medical Center in Boston led the study to determine how patients feel about converting to EMRs. Key findings suggest patients want full access to all of their medical records, are willing to make some privacy concessions in the interest of making them transparent and fully expect that computers will play a major role in their medical care, even substituting for face-to-face care.

"Year after year, people have seen information technology transform one industry after another and, more to the point, transform their everyday experiences," said Stephen Downs, assistant vice president of the health group at the Robert Wood Johnson Foundation, which supported the research through a grant from its Pioneer Portfolio. "This is the age of the iPhone, Facebook and Google Maps, yet healthcare feels very much the same. This study suggests that people are ready for change – they want a modern healthcare experience."

"We set out to study patient attitudes toward electronic personal health records and other emerging and future electronic health information technologies," said the study's lead author, Jan Walker, an instructor in medicine in the Division of General Medicine and Primary Care at Beth Israel and Harvard Medical School. "And we learned that, for the most part, patients are very comfortable with the idea of computers playing a central role in their care."

Walker said patients not only want computers to bring them customized medical information, but fully expect to be able to rely on electronic technology in the future for many routine medical issues.

"Patients know how busy their doctors are and they want to reserve us for what they really need us for – treating serious illness and conditions," said senior author Tom Delbanco, MD, the Richard and Florence Koplow-James Tullis Professor of General Medicine and Primary Care at Harvard Medical School and Beth Israel. "They may be more than happy to rely on computer protocols and 'faceless doctors' to help them manage garden-variety medical problems."

"The patient's view is critical," said Delbanco. "We healthcare professionals think we know what it is, but we're often too arrogant to ask. We want our healthcare system to be as patient-centered as possible, and patients have broad and deep experience with technology in other sectors of their lives."

The study held focus groups in Boston, Portland, Maine; Tampa, Fla; and Denver. The locations were selected to represent various geographic areas, include rural and urban populations and incorporate ethnic and cultural diversity. Six of the eight groups (consisting of nine to 12 participants each) were made up of consumers. The last two groups were made up of healthcare professionals from Boston and Denver, assembled to provide perspectives on the role of health information technology and compare their opinions with those of consumers.

In each case, participants were asked how they organize the information they need to manage their health and medical care and explored how they would ideally like to manage and use this information, including how technologies could address any gaps.

"The discussions showed that, for the most part, consumers want computers to take into account their personal profiles in order to bring them customized information and advice," said Walker. "They also expect that technologies will 'watch' over them, monitoring their health and giving them real-time feedback, including communicating with clinicians when needed. Participants also said they expect computers to act as 'personal coaches,' and to foster self care."

"It seems that as the population ages and finds itself facing more illness and serious medical conditions, privacy of health information becomes much less important to patients than it is when they are healthy," Walker said. "Patients are willing to trade some privacy in order to have records fully available in emergency settings and available to new caregivers as well as to multiple clinicians."

Reader Comments (2)Login to Post a Comment

Gpark1018 says: The debate on where data should reside...

June 01, 2009 | 9:07AM GMT

You can read a greater debate on this topic by checking out the LINKEDIN HIMSS Group Discussion titled "HIE or PIE".

It's a fascinating conversation that must be discussed as we figure out how we are going to spend our 19 billion.

Gpark1018 says: Now What?

May 26, 2009 | 9:00AM GMT

Consumers want to have access to their data. They want their PHR to interact with data collected from each clinical provider when they receive care.

In the future we may want life-style decisions interfaced as well, ie. our exercise habits, food choices and other recreational decisions. Perhaps some day in the future these life choices will automatically interface with our PHR (interface from the gym, from credit card purchases etc).

The real question is where will this data reside? We have to ask ourselves as consumers if we want our clinical data transmitted regionally and nationally. Will we trust the mechanisms put into place to store and transfer our personal data. Perhaps, and the report suggests that consumers are willing to give us some personal freedoms.

I contend we should discuss the option of personally owned health data. I can't think of a more effective and pervasive transport method than the patient themselves. If we want to own our data, then let us receive it...add it ourselves to our PHR, and be responsible for providing that data at each new clinical encounter.