Patient Participation in the Problem-Oriented System: A Health Care Plan

Hertz, Charles G.; Bernheim, Joseph W.; Perloff, Thomas N.

doi:10.1097/00005650-197601000-00008

Cited by 24 publications

(7 citation statements)

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“…Several of these studies have also demonstrated improvements in adherence [ 17 , 18 ] and satisfaction with doctor-patient communication [ 19 , 20 ] . Most studies also did not find that patient-accessible medical records increased subjective workload [ 4 - 6 , 19 ], although a randomized trial of hospitalized patients demonstrated increased time spent answering patient questions [ 3 ]. With regard to the use of SPPARO over time, we found that use of the system was initially high, and then leveled off.…”

Section: Discussionmentioning

confidence: 99%

Providing a Web-based Online Medical Record with Electronic Communication Capabilities to Patients With Congestive Heart Failure: Randomized Trial

Se¹,

Moore²,

Earnest³

et al. 2004

J Med Internet Res

253

309

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BackgroundIt is possible to provide patients with secure access to their medical records using the Internet. Such access may assist patients in the self-management of chronic diseases such as heart failure.ObjectiveTo assess how a patient-accessible online medical record affects patient care and clinic operations. The SPPARO (System Providing Access to Records Online) software consisted of a web-based electronic medical record, an educational guide, and a messaging system enabling electronic communication between the patient and staff.MethodsA randomized controlled trial was conducted in a specialty practice for patients with heart failure. Surveys assessing doctor-patient communication, adherence, and health status were conducted at baseline, 6 months, and 1 year. Use of the system, message volume, utilization of clinical services, and mortality were monitored.ResultsOne hundred and seven patients were enrolled (54 intervention and 53 controls). At 12 months, the intervention group was not found to be superior in self-efficacy (KCCQ self-efficacy score 91 vs. 85, p=0.08), but was superior in general adherence (MOS compliance score 85 vs. 78, p=0.01). A trend was observed for better satisfaction with doctor-patient communication. The intervention group had more emergency department visits (20 vs. 8, p=0.03), but these visits were not temporally related to use of the online medical record. There were no adverse effects from use of the system.ConclusionsProviding patients with congestive heart failure access to an online medical record was feasible and improved adherence. An effect on health status could not be demonstrated in this pilot study.

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Section: Discussionmentioning

confidence: 99%

Providing a Web-based Online Medical Record with Electronic Communication Capabilities to Patients With Congestive Heart Failure: Randomized Trial

Se¹,

Moore²,

Earnest³

et al. 2004

J Med Internet Res

253

309

View full text Add to dashboard Cite

show abstract

“…Studies that provided only a truncated version of the medical record were also considered relevant if they included a doctor-generated list of medical problems at a minimum. [31][32][33][34] Studies that did not include full or abridged medical notes were not counted as clinical trials, although they provided background information about patients' reactions to the concept of a patient-accessible medical record. 10,[35][36][37][38][39] Studies that gave patients only computerized reminders for health care maintenance were not included and have been reviewed elsewhere.…”

Section: Methodsmentioning

confidence: 99%

“…10,[35][36][37][38][39] Studies that gave patients only computerized reminders for health care maintenance were not included and have been reviewed elsewhere. 40 Clinical trials of patient-accessible medical records were performed with medical outpatients, 9,[31][32][33][34][41][42][43][44][45][46][47][48][49] medical inpatients, 50,51 obstetric outpatients, [52][53][54][55][56] psychiatric inpatients, [57][58][59] and psychiatric outpatients. 60,61 These trials used heterogeneous methods of providing medical records and assessing outcomes.…”

Section: Methodsmentioning

confidence: 99%

The Effects of Promoting Patient Access to Medical Records: A Review

Lin

2003

J Am Med Inform Assoc

266

215

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The Health Insurance Privacy and Portability Act (HIPPA) stipulates that patients must be permitted to review and amend their medical records. As information technology makes medical records more accessible to patients, it may become more commonplace for patients to review their records routinely. This article analyzes the potential benefits and drawbacks of facilitating patient access to the medical record by reviewing previously published research. Previous research includes analysis of clinical notes, surveys of patients and practitioners, and studies of patient-accessible medical records. Overall, studies suggest the potential for modest benefits (for instance, in enhancing doctor-patient communication). Risks (for instance, increasing patient worry or confusion) appear to be minimal in medical patients. The studies, however, were of limited quality and low statistical power to detect the variety of outcomes that may result from implementation of a patient-accessible medical record. The data from these studies lay the foundation for future research.

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“…In a survey of studies related to patient access to their medical records, generally, patients who chose to see their records were satisfied with their contents [1-4] and felt greater autonomy about their care [1,5,6]. Granting patients access to their records also does not increase the workload of medical staff members [1,7-9]. Generally, patient access to EHRs can lead to positive health outcomes and greater understanding of their conditions [1,10,11].…”

Section: Introductionmentioning

confidence: 99%

Improving Electronic Health Record Note Comprehension With NoteAid: Randomized Trial of Electronic Health Record Note Comprehension Interventions With Crowdsourced Workers

Lalor¹,

Woolf²,

Yu³

2019

J Med Internet Res

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BackgroundPatient portals are becoming more common, and with them, the ability of patients to access their personal electronic health records (EHRs). EHRs, in particular the free-text EHR notes, often contain medical jargon and terms that are difficult for laypersons to understand. There are many Web-based resources for learning more about particular diseases or conditions, including systems that directly link to lay definitions or educational materials for medical concepts.ObjectiveOur goal is to determine whether use of one such tool, NoteAid, leads to higher EHR note comprehension ability. We use a new EHR note comprehension assessment tool instead of patient self-reported scores.MethodsIn this work, we compare a passive, self-service educational resource (MedlinePlus) with an active resource (NoteAid) where definitions are provided to the user for medical concepts that the system identifies. We use Amazon Mechanical Turk (AMT) to recruit individuals to complete ComprehENotes, a new test of EHR note comprehension.ResultsMean scores for individuals with access to NoteAid are significantly higher than the mean baseline scores, both for raw scores (P=.008) and estimated ability (P=.02).ConclusionsIn our experiments, we show that the active intervention leads to significantly higher scores on the comprehension test as compared with a baseline group with no resources provided. In contrast, there is no significant difference between the group that was provided with the passive intervention and the baseline group. Finally, we analyze the demographics of the individuals who participated in our AMT task and show differences between groups that align with the current understanding of health literacy between populations. This is the first work to show improvements in comprehension using tools such as NoteAid as measured by an EHR note comprehension assessment tool as opposed to patient self-reported scores.

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Patient Participation in the Problem-Oriented System: A Health Care Plan

Cited by 24 publications

References 0 publications

Providing a Web-based Online Medical Record with Electronic Communication Capabilities to Patients With Congestive Heart Failure: Randomized Trial

Providing a Web-based Online Medical Record with Electronic Communication Capabilities to Patients With Congestive Heart Failure: Randomized Trial

The Effects of Promoting Patient Access to Medical Records: A Review

Improving Electronic Health Record Note Comprehension With NoteAid: Randomized Trial of Electronic Health Record Note Comprehension Interventions With Crowdsourced Workers

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