Adoption of an Electronic Patient Record Sharing Pilot Project: Cross-Sectional Survey

Abstract

Background The Public Private Interface–Electronic Patient Record (PPI-ePR) system was implemented as a new electronic platform to facilitate collaboration between the public and private sectors in Hong Kong. However, its barriers to participate and benefits have not been comprehensively assessed. Objective This study aimed to evaluate the awareness, acceptance, perceived benefits, and obstacles to participation among private doctors and the general public. Methods From December 2012 to January 2013, 2435 telephone interviews were performed by trained interviewers to survey randomly selected patients who were enrolled or not enrolled in the PPI-ePR system. In addition, self-administered surveys were sent by postal mail to 4229 registered doctors in Hong Kong. The questionnaires for both patients and doctors contained questions on subjects’ awareness, acceptance, and perceptions of the PPI-ePR, perceived benefits and obstacles of participating in the program, reasons for not using the system after enrolling, and perceived areas for service improvement of the system. Results More than 53.1% (266/501) of enrolled patients believed that the PPI-ePR system would improve health care quality by reducing duplicate tests and treatments, while more than 76.8% (314/409) of enrolled doctors emphasized timely access to patients’ medical records as the biggest benefit of their enrollment. Among nonenrolled patients, unawareness of the project was the most popular obstacle to enrolling in the PPI-ePR system (483/1200, 40.3%). Regarding nonenrolled doctors, the complicated registration process hindered them from participating in the program the most (95/198, 48.0%). Television, newspaper, and magazine advertisements and medical profession newsletters or journals were suggested as the most effective means to encourage participation in the program among surveyed patients (1297/1701, 76.2%) and doctors (428/610, 70.2%), respectively. Lack of clinical indication requiring data extraction from other hospitals was the main reason for low level of PPI-ePR use. Conclusions This study comprehensively assessed the popularity, perceived benefits, and hindering factors of enrolling in the PPI-ePR system in Hong Kong. Low levels of awareness, few privacy concerns, and inactive use of the PPI-ePR system were among the key features for patients and physicians. Public promotions, simplified logistics, and a user-friendly online interface were suggested to improve the coverage and effectiveness of health information exchange between private and public health care sectors.

Capturing the Impact of Patient Portals Based on the Quadruple Aim and Benefits Evaluation Frameworks: Scoping Review

“…Many of the studies [ 47 , 68 , 77 , 80 , 82 , 100 , 101 , 109 - 112 , 114 ] have explored patient experiences with access to patient portals and subsequently access to their own medical information. All of the studies reported that users were highly satisfied with the access, and in one study, 97% of survey respondents stated that they would definitely or probably recommend the portal to other clients and families [ 110 ].…”

“…In total, 18 studies [ 40 - 42 , 50 , 51 , 54 , 55 , 57 , 64 , 66 , 82 , 87 , 120 - 125 ] and 3 reports [ 114 , 126 , 127 ] addressed the health care workforce perspective through various methods (mixed methods, n=7; prospective observational, n=2; qualitative, n=6; and surveys, n=6), with a focus on conducting formative and process evaluations. A total of 11 studies were conducted in the United States, 5 in Sweden, 4 in Canada, and 1 in China.…”

“…Many studies concluded that the health care workforce had a direct impact on portal adoption and utilization by patients [ 55 , 66 , 82 , 126 ]. Although paper access to medical records had always been obtainable and not seen as contentious, real-time access had been associated with concerns about privacy and security and led to discontent and low uptake by providers [ 120 , 123 , 124 ].…”

Capturing the Impact of Patient Portals Based on the Quadruple Aim and Benefits Evaluation Frameworks: Scoping Review (Preprint)

“…Many of the studies [47,68,77,80,82,100,101,[109][110][111][112]114] have explored patient experiences with access to patient portals and subsequently access to their own medical information. All of the studies reported that users were highly satisfied with the access, and in one study, 97% of survey respondents stated that they would definitely or probably recommend the portal to other clients and families [110].…”

“…In total, 18 studies [40][41][42]50,51,54,55,57,64,66,82,87,[120][121][122][123][124][125] and 3 reports [114,126,127] addressed the health care workforce perspective through various methods (mixed methods, n=7; prospective observational, n=2; qualitative, n=6; and surveys, n=6), with a focus on conducting formative and process evaluations. A total of 11 studies were conducted in the United States, 5 in Sweden, 4 in Canada, and 1 in China.…”