Use of a patient-accessible electronic medical record in a practice for congestive heart failure: patient and physician experiences.
OBJECTIVE
The aim of this study was to evaluate the experiences of patients and physicians in a clinical trial of an online electronic medical record (SPPARO, System Providing Patients Access to Records Online).


METHODS
Quantitative data were obtained from questionnaires. Qualitative data were obtained from individual interviews and focus groups.


METHODS
Questionnaire items were based on issues identified by patients and physicians in previous studies. Individual interviews and focus groups were performed using a semistructured format developed through an iterative process.


RESULTS
Of the eight physicians who participated in the trial, seven completed questionnaires and interviews. Of the 394 patients in the practice, 107 enrolled in the study, and 54 were assigned randomly to the intervention group. Of these, 41 used SPPARO during the trial period. In questionnaires and interviews, patients were significantly more likely than physicians to anticipate benefits of SPPARO and less likely to anticipate problems. Attitudes of subjects did not diverge from controls after the intervention period. In posttrial focus groups, SPPARO users described its practical benefits. Comprehending medical jargon was a minor obstacle. Physicians anticipated that implementing SPPARO might increase their workload and distort their clinical interactions. In posttrial interviews, physicians and staff reported no change in their workload and no adverse consequences. All of the physicians ultimately supported the concept of giving patients online access to their clinical notes and test results.


CONCLUSIONS
SPPARO was useful for a number of patients. Physicians initially voiced a number of concerns about implementing SPPARO, but their experience with it was far more positive.
Earnest
Mark A
MA
Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, USA.
Ross
Stephen E
SE
Wittevrongel
Loretta
L
Moore
Laurie A
LA
Lin
Chen-Tan
CT
D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D005260:Female; D017144:Focus Groups; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D033283:Patient Access to Records; D011795:Surveys and Questionnaires