title: Transforming patient and family access to medical information: utilisation patterns of a patient-accessible electronic health record.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the utilisation of a web-based multimedia patient-accessible electronic health record, for patients with congenital cardiac disease.
  
  
  METHODS
  This was a prospective analysis of patients undergoing congenital cardiac surgery at a single institution from 1 September, 2006 to 1 February, 2009. After meetings with hospital administration, physicians, nurses, and patients, we configured a subset of the cardiac program's web-based clinical electronic health record for patient and family access. The Electronic Health Record continuously measured frequency and time of logins, logins during and between hospitalisations, and page views by type (imaging versus textual data).
  
  
  RESULTS
  Of the first 270 patients offered access to the system, 252 became users (93% adoption rate). System uptime was 99.9%, and no security breaches were reported. Users accessed the system more often while the patients were in hospital (67% of total logins) than after discharge (33% of total logins). The maximum number of logins by a family was 440, and the minimum was 1. The average number of logins per family was 25. Imaging data were viewed significantly more frequently than textual data (p 0.001). A total of 12 patients died during the study period and 11 members of their families continued to access their Electronic Health Records after the date of death.
  
  
  CONCLUSIONS
  A web-based Patient Accessible Electronic Health Record was designed for patients with congenital cardiac disease. The adoption rate was high, and utilisation patterns suggest that the Electronic Health Record could become a useful tool for health information exchange.
authors.affiliation: Department of Cardiovascular Surgery, Miami Children's Hospital, Congenital Heart Institute, Florida, USA. Redmond111@aol.com
authors.forename: Redmond P
authors.initials: RP
authors.lastname: Burke
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Rossi
authors.forename: Bryan R
authors.initials: BR
authors.lastname: Wilner
authors.forename: Robert L
authors.initials: RL
authors.lastname: Hannan
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Zabinsky
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: White
mesh_terms: D000293:Adolescent; D001292:Attitude to Computers; D002648:Child; D057286:Electronic Health Records / Q000458:organization & administration*; D005190:Family; D005260:Female; D055991:Health Records, Personal; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D020407:Internet; D008297:Male; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D019212:Multimedia; D033283:Patient Access to Records; D011446:Prospective Studies; D015203:Reproducibility of Results