Survey Reveals Patients' Perspectives on EHRs

I spend a lot of time studying and understanding EHRs. I am a “superuser” within both the inpatient facility in which I have medical staff privileges, and in the private outpatient practice. I made the leap to EHRs more than two years ago, and haven’t looked back.

I can honestly say that the two EHRs I use have improved patient care, documentation, accuracy, and quality of life for me. I realize that systems vary, but I feel fortunate that I have good tools for accessing and using the EHR.

We seem to always talk about the EHR from the perspectives of the provider, facility, and the system. But what about the patient? That seems to be an afterthought in this process. How can we leverage the data that we are collecting and storing to make the patient's experience more inclusive and meaningful to improve the health or our communities?

The National Partnership for Women and Families just published a survey that demonstrates that patients also value the EHR, and are eager for more access and features in better understanding their healthcare and options.

Here are some of the key findings from the survey of 2,045 U.S. adults:

• Eighty-five percent to 96 percent of all respondents found EHRs useful in various aspects of care delivery, while only 57 percent to 68 percent saw paper records as useful.

• Patients’ online access to EHRs has nearly doubled, surging from 26 percent in 2011 to 50 percent in 2014.

• Patients want even more robust functionality and features of online access than are available today, including the ability to e-mail providers (56 percent); review treatment plans (56 percent), review of doctors’ notes (58 percent), and and review of test results (75 percent). They also want the ability to schedule appointments (64 percent), and submit medication refill requests (59 percent).

• Patients’ trust in the privacy and security of EHRs has increased since 2011, and patients with online access to their health information have a much higher level of trust in their doctor and medical staff (77 percent) than those with EHRs that don’t include online access (67 percent).

• Different populations prefer and use different health IT functionalities. For instance, Hispanic adults were significantly more likely than non-Hispanic Whites (78 percent vs. 55 percent) to say that having online access to their EHR increases their desire to do something about their health; and African American adults were among the most likely to say that EHRs are helpful in finding and correcting medical errors and keeping up with medications. Specialized strategies may be necessary to improve health outcomes and reduce disparities in underserved populations.

In many ways, the survey findings really surprised me, as this is the first time that I have seen substantial survey data about how patients see the whole process of the EHR. Their understanding of the utility of the EHR was refreshing.

Some findings raise concerns, however. Patients' desire to have more electronic access may be problematic. Think of the increased workload in responding to a new access point, and the potential for misunderstandings and conflict in care plans if diagnostic data and records can be viewed unfiltered and without the assistance of the care provider.

On the other hand, the EHR seems to provide at least some of the tools that a provider needs to improve health outcomes and reduce healthcare disparities among diverse populations. It was good to see that the EHR was seen by some ethnic populations as a way to motivate them to be healthier and to take more responsibility and control of their healthcare.

Much has yet to be learned and uncovered in the wake of the push to automate and digitalize the health record in the United States. Sometimes the law of unintended consequences can work in the favor of the healthcare system.

One fact remains for all providers, learning to survive in the post-EHR world, and acquiring the skills needed to become efficient in the use of the EHR, have never been more important. There is no going back to the paper record.

This blog was provided in partnership with the American Academy of Physician Assistants.