title: Impact of patient-accessible electronic medical records in rheumatology: use, satisfaction and effects on empowerment among patients.
abstract: BACKGROUND
  To measure the use, satisfaction and impact of a web portal which provides patients with rheumatoid arthritis home access to their electronic medical records (EMR).
  
  
  METHODS
  A pretest-posttest study was conducted among 360 patients. Questionnaires assessed socio-demographics, health literacy, Internet use, disease characteristics, patient-provider relationship and empowerment before and after launching a hospital-based patient web portal. To measure the impact of the portal, patients' satisfaction with care, trust in their rheumatologist, self-efficacy in patient-provider communication, illness perceptions, and medication adherence were assessed. The post-test included questions on portal use, satisfaction, and self-perceived impact due to portal use.
  
  
  RESULTS
  54% of respondents with Internet access had viewed their EMR. Respondents were positive about the ease of use and usefulness of the portal and reported very few problems. Age (P = .03), amount of Internet use (P = .01) and self-perceived Internet skills (P = .03) significantly predicted portal use. Of the respondents who had logged in, 44% reported feeling more involved in their treatment and 37% felt they had more knowledge about their treatment. Significant differences over time were not found on the empowerment-related instruments.
  
  
  CONCLUSIONS
  The current portal succeeded in offering patients access to their EMR in a usable and understandable way. While its true impact is difficult to grasp, a relevant portion of the patients felt more involved in their treatment due to the web portal. Offering patients home EMR access, therefore, appears to be a valuable addition to the care process.
authors.affiliation: Department of Psychology, Health & Technology, University of Twente, Citadel H423, P,O, Box 217 7500 AE, Enschede, The Netherlands. r.vandervaart@fsw.leidenuniv.nl.
authors.forename: Rosalie
authors.initials: R
authors.lastname: van der Vaart
authors.forename: Constance H C
authors.initials: CH
authors.lastname: Drossaert
authors.forename: Erik
authors.initials: E
authors.lastname: Taal
authors.forename: K Wiepke
authors.initials: KW
authors.lastname: Drossaers-Bakker
authors.forename: Harald E
authors.initials: HE
authors.lastname: Vonkeman
authors.forename: Mart A F J
authors.initials: MA
authors.lastname: van de Laar
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000523:psychology; D057286:Electronic Health Records / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D057220:Health Literacy; D006801:Humans; D020407:Internet; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D033283:Patient Access to Records; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011209:Power, Psychological; D012219:Rheumatology / Q000458:organization & administration*; D012649:Self Concept; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D035502:Trust