JMIR Publications

ABSTRACT

Background:

Electronic health records (EHR) have become standard in the healthcare setting. In an effort to improve health literacy, foster patient- provider communication, and ease the transition from adolescent to adult care, our institution created a policy that allows patients aged 13-17 to have EHR access. Literature review revealed predictable differences in portal registration between different ethnicities and socioeconomic statuses. Consequently a cross-sectional survey was developed to investigate barriers to EHR access in a sample of culturally diverse adolescents.

Objective:

Assess for barriers to EHR access in a culturally diverse adolescent population.

Methods:

A 42-item anonymous survey was completed by 97 adolescents age 13-18 attending general pediatrics clinics. Results were analyzed using descriptive statistics and t-tests.

Results:

Average participant age was 15.5 + 1.5 years with 59.8% male and 40.2% female. Participants were 44.3% Black, 41.2% Hispanic, 9.3% Caucasian, 3.1% Asian, and 2.1% other. There were statistically significant differences in perceptions of confidentiality in age (13-15 vs. 16-18; P=0.001) and insurance status (government vs. private, P=0.012), but not gender, ethnicity or parental education level. Older, privately insured girls had more confidence in the confidentiality of their relationship with their doctors. 93.8% of participants had heard the term "EHR," but only 54.6% were familiar with its function. 77.3% of patients primarily accessed the internet through phones and 50% of participants knew that patients under 18 could obtain care for mental health, substance abuse, sexual health and pregnancy.

Conclusions:

Research has identified gaps in EHR technology with regards to the pediatric patient population. Results of our survey show adolescents may have misconceptions regarding the doctor-patient relationship, their ability to obtain care, and the modalities present in an Electronic Health Record. As technology progresses, it is essential to have a deeper understanding of adolescents' perceptions of confidentiality, technology, and available resources in order to design an EHR system that encourages patient education and communication while limiting barriers to care.