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Doctors Like Electronic Medical Records, as Long as Patients Can't Touch Them


Doctors Like Electronic Medical Records, as Long as Patients Can't Touch Them

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As the use of electronic health records spreads, most doctors say they want strict controls placed on patients’ access to their digital medical records, a new study shows—a restriction that some say could undermine the general effectiveness of going digital in the first place.

According to a study by Accenture (ACN), 68 percent of U.S. doctors do not want patients to have full access to their electronic health records, even though secure access through an Internet portal is technically very feasible. The restrictions they want vary, from not wanting patients to edit their records—say, to add the results of a blood test performed out-of-network—to a minority (4 percent) who do not want patients to see their records in digital form at all.

Doctors’ preference for these restrictions compromises one of the most attractive things about electronic records: the ability for patients to be able to access their complete medical record in an instant, which could be vital in a medical emergency if they are being treated by doctor who otherwise wouldn’t know their history.

Most doctors say they are willing to allow patients to make minor changes to their records, such as updating their family medical history (88 percent) or allergies (85 percent)—the very details patients are routinely asked to fill out when they visit the doctor’s office. On the other hand, a majority does not want patients to update their own records with details on, for example, their latest lab test results, or with new symptoms they observe, or with the medication they’ve been prescribed.

“Most doctors are just not ready to grant their patients unfettered access,” said Kaveh Safavi, managing director of Accenture’s North America health business. American physicians are not alone in wanting restrictions to EHR access, he added, saying that a similar proportion of non-U.S. doctors surveyed in the same eight-nation study feel the same way.

Physicians’ concerns come down to an issue of trust and accuracy, Safavi says. When several people can access a file, it increases the risk of adding confusing or incorrect information. Most of us have trouble spelling “amoxicillin,” after all, and a misplaced decimal point on a lab test result could seriously distort a patient’s medical outlook.

In practice, patients are routinely being denied the rights to simply review records. Accenture found that 21 percent of doctors surveyed give patients online access to their electronic charts and only one in five (20 percent) give patients access to their personal records or to those of a family member on a secure website.

Safavi believes doctors will over time come to better trust their patients with access to their own records. For now, the market is spending billions—$24 billion in 2012—on technologies that still fall short of electronic records’ full potential.

Warner writes about innovation for Bloomberg Businessweek. Follow him on Twitter @bernhardwarner.

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