The Impact of Accessing Medical Records on Care Coordination and Disease Management
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Abstract
Background: Although Personal Health Record (PHR) systems allow individuals to access to their medical records, only a small number of patients currently manage their entire medical records themselves. The benefits of individuals accessing to medical records include: empowering patients to actively manage diseases, improving patient-provider relationships, and facilitating care coordination process. Understanding how individuals manage their lifelong records would increase the functionality and usability of the future PHR system design.
Objective: The goal of this study is to examine the long-term impact of accessing and managing medical records on care and disease management behaviors among physicians and patients.
Method: This study examines medical record management practices in urban China, where patients maintain ambulatory medical records themselves. Consequently, patients have to keep their complete medical records from multiple providers at home.
This study deployed field observations and semi-structured interviews methods to investigate patients’ records keeping and usage behaviors. 4 physicians and 76 patients visits were shadowed for totally 60 hours. In addition, 18 semi-structured interviews were conducted to patients or family members.
Results: Overall, patients displayed a strong sense of ownership over their medical records and enjoyed being able to manage their own medical records. Most patients prefer to keep their records at home because if the convenience of accessing medical information at anytime, anywhere, especially for those who have chronic or serious diseases. Patients have engaged in multiple personal health information management activities associated with medical records usages. They initiate active learning strategies to comprehend the medical information on their own and build their lifelong information repositories for disease management proposes.
Medical records serve as a key information source for care coordination during clinical practice. Patients always bring in their entire medical history to the consulting room. Instead of inquiring about symptoms and medical histories, the first step of medical consultation is to check the records brought in by patients, no matter it is from the same provider or not. The records are brought in by patients and contain information received from multiple providers including diagnoses, prescriptions, lab results and even radiologist images. Physicians are able to view and consider diagnoses, prescriptions and test results from other providers. Accordingly, they can make prompt and informed decisions to avoid possible drug interactions, repetitive checks and prolonged waiting times.
Conclusion: The patterns of medical records usages examined in this study suggest that individual access to medical records enables effective care coordination and empowers patients to engage in more active health information organization, management and learning process. These usage patterns can be used to inform future PHR system design to accommodate the needs of records management behaviors among individuals. Future studies will be carried out to examine issues of trust, privacy, and patient-provider relationships in the context of individual accessing to medical records and to apply survey methods to quantitatively validate these findings.
Objective: The goal of this study is to examine the long-term impact of accessing and managing medical records on care and disease management behaviors among physicians and patients.
Method: This study examines medical record management practices in urban China, where patients maintain ambulatory medical records themselves. Consequently, patients have to keep their complete medical records from multiple providers at home.
This study deployed field observations and semi-structured interviews methods to investigate patients’ records keeping and usage behaviors. 4 physicians and 76 patients visits were shadowed for totally 60 hours. In addition, 18 semi-structured interviews were conducted to patients or family members.
Results: Overall, patients displayed a strong sense of ownership over their medical records and enjoyed being able to manage their own medical records. Most patients prefer to keep their records at home because if the convenience of accessing medical information at anytime, anywhere, especially for those who have chronic or serious diseases. Patients have engaged in multiple personal health information management activities associated with medical records usages. They initiate active learning strategies to comprehend the medical information on their own and build their lifelong information repositories for disease management proposes.
Medical records serve as a key information source for care coordination during clinical practice. Patients always bring in their entire medical history to the consulting room. Instead of inquiring about symptoms and medical histories, the first step of medical consultation is to check the records brought in by patients, no matter it is from the same provider or not. The records are brought in by patients and contain information received from multiple providers including diagnoses, prescriptions, lab results and even radiologist images. Physicians are able to view and consider diagnoses, prescriptions and test results from other providers. Accordingly, they can make prompt and informed decisions to avoid possible drug interactions, repetitive checks and prolonged waiting times.
Conclusion: The patterns of medical records usages examined in this study suggest that individual access to medical records enables effective care coordination and empowers patients to engage in more active health information organization, management and learning process. These usage patterns can be used to inform future PHR system design to accommodate the needs of records management behaviors among individuals. Future studies will be carried out to examine issues of trust, privacy, and patient-provider relationships in the context of individual accessing to medical records and to apply survey methods to quantitatively validate these findings.
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