Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 2, 2020
Date Accepted: Jan 21, 2021
Patients’ Ability to Review Electronic Health Record Information to Identify Potential Errors: A Pilot Qualitative Study
ABSTRACT
Background:
Sharing personal health information positively impacts quality of care across several domains, and particularly safety and patient-centeredness. Patients when reading their electronic health records (EHRs) may identify and flag up inconsistencies, leading to improved information quality and patient safety. However, in order to identify potential errors, patients need to be able to understand the information contained in their electronic records.
Objective:
This study assesses patients’ ability to identify errors present in their EHRs. Specifically, it evaluates the degree to which patients comprehend the information in their EHRs, what barriers exist to their understanding, and what, if any, errors patients can identify when given access to their EHRs.
Methods:
A cross-sectional online survey was undertaken between March 2017 and September 2017. A total of 682 registered users of the Care Information Exchange patient portal, with at least one access during the time of the study, were invited to complete the survey containing both structured (multiple choice) and unstructured (free-text) questions. The survey contained questions on patients’ perceived ability to understand their EHR information and therefore to identify errors. Free-text questions allowed respondents to expand on the reasoning behind their structured responses and provide more detail about their perceptions of EHRs and identifying errors within them. Qualitative data was systematically reviewed by two independent researchers using the framework analysis method, in order to identify emerging themes.
Results:
A total of 160 participants completed the survey (response rate=23.5%). The majority of participants (68.7%) reported they understood the information. The main barriers identified were information-related (medical terminology and knowledge, and interpretation of test results) and technology-related (user-friendliness of the portal, information display). Participants identified inconsistencies relating to incomplete and incorrect information in 14% of their records.
Conclusions:
While the majority of patients reportedly understand the information contained within their EHRs, both technology and information-based barriers persist. There is a potential to improve system design to better support opportunities for patients to identify errors. This is with the aim of improving the accuracy, quality and timeliness of the information held in the EHRs and also a mechanism to further engage patients in their heath and healthcare. Clinical Trial: Not applicable
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