Engaged healthcare consumers and electronic personal health records: An opportunity for patient-provider partnerships or not?

BACKGROUND Health informatics as a vehicle to improve healthcare quality and safety is rapidly gaining momentum. Patients have increasing opportunities to become engaged healthcare consumers by accessing electronic personal health records (PHR). We examined perceptions of PHR users participating in an Agency for Healthcare Research and Quality hypertension study in an outpatient setting at Georgia Health Sciences University.

OBJECTIVES Patient and provider perceptions of PHRs, usage, barriers, and strategies to overcome barriers are presented. METHODS Post-study, structured interviews were conducted with a sample of PHR users (N=86) seen in General Internal Medicine and Family Practice clinics. Semi-structured post-study interviews and focus groups were conducted with 29 clinicians. Participants completed a self-administered Patient Empowerment Scale (PES) to assess perceptions about patient's access to medical records.

RESULTS Perceptions of advantages, disadvantages, ethical issues, factors enabling use, and barriers were expressed. Physicians were as likely as patients to perceive benefits from PHR in both the PES and interviews (78% compared to 74%). But, physicians were more likely to identify barriers and concerns surrounding PHR use (63%) compared to patients (27%). Patients' most frequent theme about PHR usefulness was the ability to track their medical data using graphs and charts, closely followed by data review and updating, and medications management. Eighty-seven percent (62/71 respondents) reported the PHR helped them feel more responsible for their health.

DISCUSSION Despite reservations, the PHR was perceived as important for patient empowerment, enabling chronic disease management, patient-provider communication, and healthcare continuity. Education/training and careful design were suggested to facilitate effective PHR use and accessibility for patients with varied literacy levels and computer competencies.