title: Changing attitudes towards online electronic health records and online patient documentation in rheumatology outpatients.
abstract: OBJECTIVE
  The Internet supports interactive patient assessments, online documentation and access to online electronic health records (EHRs), but little is known about the acceptance of these features and trends in rheumatology patients. Therefore, we studied patients' attitudes and willingness to participate in online patient (self-)documentation.
  
  
  METHODS
  We interviewed 153 consecutive outpatients with rheumatoid arthritis, systemic lupus erythematosus or spondyloarthritis using a paperbased self-administered questionnaire. To detect recent trends in patients' perception we compared our 2006 data to the results of our survey conducted in 2001. P-values provided in the abstract reflect the comparisons from 2001 and 2006.
  
  
  RESULTS
  Patients were predominantly female (69.3%; n.s.), mean age was 45.7+/-14.4 years (n.s.), and 68.6% (+18.6% compared to 2001; p<0.001) reported regular Internet use. Confidence in the Internet and reliability of online information were rated unchanged to 2001. Internet users appreciated to access their EHR online in 68.6% (+13.8% compared to 2001; p<0.01), (self-)monitor the course of their disease online in 80.0%, and answer outcome questionnaires online in 67.6%. Internet users considered computers as valuable instruments in the patient-doctor relationship (88.4%), 58.8% were not convinced that computer use influences the relationship positively.
  
  
  CONCLUSIONS
  Attitudes of patients with rheumatic disorders (Internet users and non-users) towards online EHRs have improved since 2001, online applications for patient assessments and disease (self-)management in rheumatology seem feasible now. Nevertheless, unchanged low confidence rates in the Internet and in the reliability of medical information derived from the Internet should sound a note of caution regarding the implementation of such services.
authors.affiliation: Department of Endocrinology, Diabetes and Rheumatology, University Hospital Duesseldorf, Heinrich-Heine-University Düsseldorf, Germany. richter@rheumanet.org
authors.forename: Jutta G
authors.initials: JG
authors.lastname: Richter
authors.forename: Arnd
authors.initials: A
authors.lastname: Becker
authors.forename: Tobias
authors.initials: T
authors.lastname: Koch
authors.forename: Reinhart
authors.initials: R
authors.lastname: Willers
authors.forename: Mirco
authors.initials: M
authors.lastname: Nixdorf
authors.forename: Ben
authors.initials: B
authors.lastname: Schacher
authors.forename: Robert
authors.initials: R
authors.lastname: Monser
authors.forename: Christof
authors.initials: C
authors.lastname: Specker
authors.forename: Rieke
authors.initials: R
authors.lastname: Alten
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
mesh_terms: D000328:Adult; D001292:Attitude to Computers; D004282:Documentation; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010817:Physician-Patient Relations; D012216:Rheumatic Diseases / Q000523:psychology* / Q000628:therapy; D012219:Rheumatology