JMIR Publications

ABSTRACT

Background:

Patient portals with access to electronic health records (EHRs) offer a means for patients to better understand their health issues and self-manage their health. Yet, patient access to EHR raises many concerns among physicians, and little is known about patients’ use practices and experiences of online access to EHR when there is long-term use.

Objective:

We aimed to identify patients’ experiences of using a national patient portal and accessing their EHR. In particular, we focused on understanding how patients perceive the benefits and challenges of reading clinical notes written by health professionals.

Methods:

Data was collected through an online survey of 3139 patient users of the My Kanta patient portal in Finland. Patients received an invitation to complete the questionnaire when they logged out of the patient portal. Respondents were asked about the subjective usability of the patient portal, the usefulness of the features, and whether they had discussed the notes with health professionals. Open-ended questions were used to ask about respondents’ experiences of the benefits and challenges of reading health professionals’ notes to collect information on the most relevant issues from the patients’ perspectives.

Results:

Overall, the evaluations of My Kanta were positive, and its usability was rated to be good (The approximation of the System Usability Scale (SUS) score was 72.7, SD = 15.9). Patients found the portal to be the most useful for managing prescriptions and viewing the results of examinations and medical notes. Viewing the notes was the most frequent reason (31.6%) for visiting the portal. The experienced benefits of reading the notes were remembering and understanding what was said by health professionals and the types of instructions they gave during an appointment, conveniently receiving information about health and care, the capability of checking the accuracy of notes, and support for self-management. However, the challenges were related to the difficulty in understanding medical terminology, incorrect or inadequate notes, missing notes, and usability.

Conclusions:

Patients actively used medical notes to receive information and take care of their health. The challenges experienced mostly interfered with the benefits of reading the notes. The findings revealed that patient access to EHR can support self-management. However, for the suggested benefits to be realized, improvements in the quality and availability of medical professionals’ notes are necessary. Providing a standard information structure also helps patients find the information they need. Further, linking the notes to vocabularies and other information sources could also improve the understandability of medical terminology.