Doctors opposed to full patient access to medical records

The majority of Australian doctors say sharing health records electronically has a positive effect on reducing medical errors and improving the quality of diagnostic and treatment decisions, but that they were not in favour of allowing patients to have full access to those records.

The findings are from of a global survey carried out by Accenture late last year of 3700 doctors in eight countries looking at the use of IT in healthcare.

Five hundred doctors in Australia were surveyed, with 83 per cent saying they were actively using electronic medical records and roughly 70 per cent reporting improved quality of diagnostic and treatment decisions as a result of their use of shared electronic health records.

In terms of patient access to records, the survey found that 83 per cent want patients to actively participate in their own healthcare by updating their electronic health records. However, the majority believe that patients should only have limited access to this record, a view shared across the surveyed countries.

According to the survey, there was broad agreement among Australian doctors that patients should be able to update standard information in their health records, including demographics (87 per cent) and family medical history (78 per cent).

However, a significant proportion of doctors were opposed to patients providing updates in areas such as medications (29 per cent), medication side effects (28 per cent), allergic episodes (26 per cent) and lab test results (59 per cent). The level of opposition to such patient input was notably higher than most other countries, the survey found.

Only 18 per cent believe that a patient should have full access to his or her own record, 65 per cent believe patients should have limited access and 16 per cent say they should have no access.

Accenture, which was the lead partner in the consortium that built the PCEHR, said Australia ranked second highest of the eight countries surveyed in the proportion of doctors that say patients should have no access to their record.

Leigh Donoghue, managing director of Accenture's health business in Australia and New Zealand, said more needs to be done in terms of enabling consumers to play an active role in their own care.

“This requires a shift in the way clinicians think and interact with patients, harnessing new technologies such as electronic health records and mobile devices,” Mr Donoghue said in a statement. “From the survey, this seems to be happening faster in other countries.

“The shift to patient-centred care has long been talked about, but we’re now entering a new stage with the rise of the digital citizen and availability of electronic health records. The combination of smartphones, faster broadband, mobile access to the PCEHR system, and a growing array of mobile health applications will trigger fresh demands from consumers for more active participation in managing their own care.

“To meet changing consumer expectations, Australian doctors' views on patient access will need to evolve.”

There were some surprising findings in the survey, including that only six per cent of doctors in Australia use electronic prescribing. There also appears to have been a precipitous drop in the number of doctors who say they electronically send order requests to labs, from 22 per cent in 2011 to 12 per cent in 2012.

The criteria in the survey for ePrescribing includes that doctors can send electronic prescriptions directly to a pharmacy, which is not possible here, although doctors can use prescription exchange services. Similarly, doctors must still provide a paper pathology test request to the patient.

Mr Donoghue said the low numbers for ePrescribing and lab ordering was probably a reflection of the Australian system and local doctors' interpretation of the survey questions.

The survey found that there has been a 62 per cent increase since 2011 in the number of Australian doctors who said they routinely access electronic clinical data about patients previously seen by a different health organisation, from 26 per cent in 2011 to 42 per cent in 2012.

Australia is on par with the rest of the countries surveyed in terms of the low number who communicate electronically with patients to support remote consultation and diagnostics.

Australian doctors have also increased their routine use of other IT capabilities, including receiving patients’ clinical results electronically (67 per cent), entering patient notes during or after consultations (64 per cent) and receiving electronic alerts/reminders while seeing patients (44 per cent).

A summary of the survey is available online at the Accenture website.

Posted in Australian eHealth

Comments   

# Julia 2013-07-09 12:24
“To meet changing consumer expectations, Australian doctors' views on patient access will need to evolve.”

Don't you mean 'need to be modified' OR 'change'. Why should they 'need to evlove'? My research found the same findings some years ago when hospital doctors were surveyed. I am with the doctors!
# John 2013-07-10 17:43
there is an important issue that seems to be missed in this article. Access is a very imprecise term. We must differentiate the ability to view all or part of the record from the ability to change all or part of the record. There is a view that patients should not have the ability to change most parts of their health record. There is however an argument that they should have the ability to view their record or at least most parts of it.

Rather than using the term "access" perhaps the terms "view" and "change" should be used.

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