Background
Increasing patient demands for convenient access to their own health care information has led to the development of “patient portals” that allow limited patient access to ambulatory electronic health records (EHR). Little is known about clinicians’ attitudes towards this new model of health care. In our study, we collected baseline information about primary care providers’ (PCP) usage of a secure, web-based patient portal linked to the ambulatory EHR. We also assessed providers’ initial perceptions of these technologies as facilitators of patient-provider communications and the potential for these tools to improve quality of outpatient care.
Methods
We conducted a survey of PCPs at 11 practices within an integrated delivery system. The survey solicited providers’ attitudes regarding the impact and value of patients reviewing and commenting on EHR data specific to medications, care regimens for diabetic patients, family medical history, and health maintenance. Respondents who completed and returned the survey each received a $15 gift certificate.
Results
Of the 113 providers contacted, 72 completed and returned the survey (63.7% response rate). Among the participating providers, only 30% reported that they believe there is enough time to review all the necessary information with a patient during a visit. Over half of the respondents (52.2%) agreed that they would have to spend more time with the patient during the visit if a patient was able to view and comment on his/her EHR chart information prior to a visit. Similarly, 52.2% believed that their overall workload would increase because of the patient portal. However, 51.4% of providers reported that their knowledge and awareness of their patients’ health would increase, as would their ability to update patient data in the EHR (55.7%). 57.4% of providers reported that their ability to communicate with their patients would improve. Most providers agreed or strongly agreed that the accuracy of information documented in the EHR would improve and the knowledge and understanding on the part of the patient would increase (Table 1).
Table 1.
Providers’ perception of the impact of patients’ ability to view and comment on their medical chart information
| Survey Item | Percentage of providers who agreed or strongly agreed | |||
|---|---|---|---|---|
| Medications | Diabetic Care Regimen | Family Medical History | Health Maintenance | |
| Improve accuracy of EHR documentation | 84.7% | 87.3% | 90.0% | 92.8% |
| Increase patient knowledge and understanding | 76.4% | 74.6% | 81.2% | 89.9% |
Conclusion
Providers place great value on their patients as sources of clinical information. Despite the perceived added burden to their overall workload, most providers recognized the benefit of patients’ ability to review and comment on their medical chart information prior to a visit. Results of our survey indicate that the development of patient portals to view EHRs would likely result in improved EHR documentation, patient knowledge, and quality of care, provided that such tools support an efficient process for clinician review and incorporation of data into the EHR. The full use of patient portals may also require new ways to compensate physicians for their time. Further study is underway to evaluate the utility of such tools for patients and clinicians and their impact on workflow.