Survey finds patients increasingly value EHRs—even those whose doctors use paper records

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 - patient record, EHR, EMR

Regardless of whether or not their physicians use EHRs or paper records, patients see significant value in EHRs, according to a study released Wednesday by the National Partnership for Women & Families.

The report—“Engaging Patients and Families: How Consumers Value and Use Health IT”—was based on a survey carried out by Harris Poll assessing consumer views towards EHRs and health IT. It found that 85-96 percent of all patients found EHRs useful in various aspects of care delivery, while just 57-68 percent found paper records useful.

The National Partnership for Women & Families (NPWF) conducted a similar study in 2011 and found that since then the number of patients who have access to electronic records has grown significantly. When that survey was conducted 64 percent of adults surveyed who had doctors and knew what kind of record system they use identified that system as an EHR. That number increased to 80 percent in the current survey. In addition, patients’ online access to EHRs nearly doubled—from 26 percent in 2011 to 50 percent in 2014.

According to Mark Savage, NPWF's director of health information technology policy and programs, identified the following seven “key findings” that came out of the survey:

  • Patients find that EHRs are much more useful than paper records.
  • Patients find the basic online convenience features such as online scheduling and avoiding repeatedly filling out forms to be beneficial—as beneficial as having access to their clinical information.
  • Patients report that having more online access enhances their healthcare.
  • Patients share—and want to share—information with their healthcare providers, and want that access and communication with providers to be bi-directional.
  • Patients want better digital tools to help them manage care and plan for their health.
  • The more patients experience the benefits of EHRs and online access, the more they trust their providers to protect their privacy.
  • The benefits and barriers of EHRs and health information are not the same for everyone.

“EHR and paper-record patients alike find EHRs significantly more useful for health and healthcare,” said Savage during a conference call discussing the report. “Across the board [these patients] found EHRs are more useful by 20 percentage points or more in key domains such as helping patients follow doctors’ treatment instructions, helping take and refill medications as prescribed, and helping patients track progress towards health goals.

“Indeed, nearly half of patients whose doctors currently use paper record systems believe that switching to EHR systems would have a positive impact on the overall quality of their healthcare services,” Savage said.

The two areas where patients rated EHR systems most useful to them personally, said Savage, were sharing information with all of their providers and avoiding repeatedly filling out forms. 

Savage said that when it came to online access, “when patients had online access, 86 percent used it.” And those who more frequently accessed health information online, he said, reported a “marked greater impact across significant domains, such as knowledge of health, quality of care and sharing health information with family caregivers.”

“This reaffirms the conclusion that online access is a game changer,” he said. “And should have a great impact on improving care for patients and interoperability with patients.”

Lana Moriarty, director, Officer of Consumer eHealth, Office of the National Coordinator for Health Information Technology, also sat in on the conference call and said that the data on online access “really shows that those patients who use their information [are motivated] to do something about their health. It is powerful evidence that access does lead to action.”

Savage pointed out that one of the key findings of the survey was that the more patients experience the benefits of EHRs and online access, the more they trust their providers to protect their privacy. And conversely, the more they trust that their privacy is protected, the more they will use and benefit from EHRs.

For example:

  • 72 percent of patients with doctors who have EHRs trust them to protect their privacy “completely” or “a lot” compared to 65 percent of patients with paper records.
  • Patients with online access to EHRs trust their providers more than patients with EHRs, but without online access, by a margin of 77 to 67 percent.
  • 84 percent of patients who use their online access to EHRs more frequently (3 to 6 times or more per year) believe their providers will trust their privacy “completely” or “a lot.”
  • Patients who feel well informed about the record systems trust their doctors more than patients who don’t feel well informed by 83 percent to 56 percent.

"This really does speak to fostering a better patient-provider relationship,” Moriarty said. “And in a sense it is showing that we can build trust by providing more online access and functionality, which really goes against what people have said in the past—that people won’t use it because of trust issues.”

The survey also found that “different populations need and use different health IT functionalities,” said Savage.

For example, Hispanic adults were significantly more likely than non-Hispanic Whites (78 vs. 55 percent) to say that having online access to their EHRs increases their desire to do something about their health, while Asian-American adults were among the most likely to report that EHRs are helpful to them in sharing information with healthcare providers.

“In general the survey results show that different sub-populations value health IT for different reasons,” he said. “These insights about the specific needs, values and barriers experienced by sub-populations should provide critical guidance to policymakers on how health IT can reduce health disparities.”

As far as public health policy implications of their survey findings are concerned, the report identified several involving interoperability efforts, the federal strategic plan for health IT, payment and delivery reforms, and quality measurement, as well as the Meaningful Use program.

“Across them all,” the report states, “the findings offer insights into how policymakers should design the next phases of the Meaningful Use and other federal programs in ways that maximize the impact of health IT on patient and family engagement in health and healthcare—widely recognized as essential for improving care, improving health and reducing costs.”