title: Patient-perceived usefulness of online electronic medical records: employing grounded theory in the development of information and communication technologies for use by patients living with chronic illness.
abstract: OBJECTIVE
  Patient use of online electronic medical records (EMR) holds the potential to improve health outcomes. The purpose of this study is to discover how patients living with chronic inflammatory bowel disease (IBD) value Internet-based patient access to electronic patient records.
  
  
  METHODS
  This was a qualitative, exploratory, descriptive study using in-depth interviews and focus groups of a total of 12 patients with IBD of at least one-year duration at University Health Network, a tertiary care center in Toronto, Ontario.
  
  
  RESULTS
  Four themes have been elucidated that comprise a theoretical framework of patient-perceived information and communication technology usefulness: promotion of a sense of illness ownership, of patient-driven communication, of personalized support, and of mutual trust.
  
  
  CONCLUSIONS
  For patients with chronic IBD, simply providing access to electronic medical records has little usefulness on its own. Useful technology for patients with IBD is multifaceted, self-care promoting, and integrated into the patient's already existing health and psychosocial support infrastructure. The four identified themes can serve as focal points for the evaluation of information technology designed for patient use, thus providing a patient-centered framework for developers seeking to adapt existing EMR systems to patient access and use for the purposes of improving health care quality and health outcomes. Further studies in other populations are needed to enhance generalizability of the emergent theory.
authors.affiliation: Centre for Global e-Health Innovation, University Health Network, R. Fraser Elliott Building, 4th Floor, 190 Elizabeth Street, Toronto, Ontario, Canada. w.winkelman@utoronto.ca
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Winkelman
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Leonard
authors.forename: Peter G
authors.initials: PG
authors.lastname: Rossos
mesh_terms: D000328:Adult; D001292:Attitude to Computers; D002908:Chronic Disease; D005260:Female; D017144:Focus Groups; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D007407:Interviews as Topic; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D009862:Online Systems / Q000706:statistics & numerical data; D033283:Patient Access to Records / Q000523:psychology; D010817:Physician-Patient Relations; D012648:Self Care