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What Happens When Inpatients Have Access to Their EHRs?

AURORA, CO – Allowing patients to see their medical records while they are hospitalized will increase their anxiety while expanding the workload for hospital staff – or at least that’s the conventional wisdom.

A small study, published as a research letter recently in JAMA Internal Medicine, showed a different result, however.

A study team lead by researchers from the University Of Colorado School Of Medicine sought to find out if providing the information to hospitalized patients would allow more transparency.

“Giving outpatients direct access to their health information helps clinicians find errors and improves patient satisfaction, although the implications of this type of access have not been well studied in the inpatient setting,” the researchers note. “This hospital-based study evaluates the experiences of patients, clinicians (including physicians and advanced practice providers), and nurses with immediate (real-time) release of test results and other EHR information through a patient portal.

The prospective cohort study was performed on a medical unit of the University of Colorado Hospital in Aurora, a 412-bed academic tertiary hospital, from Oct. 1, 2012, to March 31, 2013. The 50 patients participating were provided electronic tablets to access portions of their electronic health records, including medication schedules and test results.

Surveys were completed by patients, physicians and nurses to help determine the effect on caregiver workload, patient confusion and worry, patient empowerment, errors detected and discharge planning.

While 92% of patients said beforehand that reviewing the electronic charts would help them understand their medical condition and 80% said they would be better able to understand physicians’ instructions, those percentages dropped to 82% and 60%, respectively, after EHRs were viewed.

On the other hand, patients did not become more anxious and confused, with the percentage of patients expressing worry dropping from 42% to 18% and those reporting fear of confusion declining from 52% to 32%.

Giving patients access to the information also did not create more work for physicians or nurses. While 68% of the doctors said they thought they would be asked for more time by patients before the charts were reviewed, that dropped to 36% afterwards. Responses from nurses were similar.

While hospital staff expressed initial optimism that patients would be able to spot medication errors, that view decreased across-the-board after the electronic records were shared.