Patient Engagement and Quality of Medical Records

Erin SiminerioJodi DanielPatients Play a Vital Role in Improving the Quality of Information in their Medical Records

By Erin Poetter Siminerio/ ONC Blog Team , and
Jodi G. Daniel, J.D., M.P.H./ Director of the Office of Policy and Planning

Federal incentives such as meaningful use and programs like the Blue Button Initiative are increasing patients’ electronic access to their medical records and encouraging greater engagement in their own care. That’s a good thing since medical records can contain errors. Having a “second pair of eyes” on the medical record can help improve the quality of the information that providers ultimately use to make clinical decisions. Patients, after all, know the most about their health and want to make sure their doctors have the most accurate information about them.

Results from an ONC-funded pilot project at Geisinger Health System, recently profiled in the Wall Street Journal (WSJ), demonstrate that patients can be effectively engaged online to improve the quality of the information in their medical record — helping to spot errors such as outdated information and omissions such as medications prescribed by another provider. The pilot study invited patients to provide online feedback, via a patient portal, on the accuracy of their medication list in advance of a visit to their provider.

The results:

  • Patients are eager to provide feedback on their medication list – 30 percent of patient feedback forms were completed and in 89 percent of cases, patients requested changes to their medication record.
  • Patient feedback is accurate and useful – on average, patients had 10.7 medications listed, with 2.4 requested changes. In 68 percent of cases, the pharmacist made changes to the medication list in the electronic health record based on the patient’s feedback.

As health information exchange expands, there is the potential for erroneous information to be perpetuated. There is also greater opportunity for patients to help clean up that data. And they want to help. A 2010 survey by the California Healthcare Foundation found that “making sure information is correct” is the most useful feature of a personal health record.

Yet, most institutions do not proactively solicit feedback from patients about their health records. The Health Insurance Portability and Accountability Act (HIPAA) provides individuals with the right to request an amendment to information in their record but the mechanism for providing feedback is not yet institutionalized in healthcare the way it is in other industries. The report points out that healthcare could learn a lot from other industries like financial institutions and e-commerce about how to develop effective processes for gathering and responding to user feedback.

There is a growing evidence base that supports giving patients greater access to their information as a first step towards engaging them as equal partners in their care. The OpenNotes project found that patients who were given access to their doctors’ notes reported they do better in taking their meds. Findings from the Geisinger pilot further demonstrate the value that patients can provide when they are invited to participate more fully in their care.

We would like to thank the National Opinion Research Center (NORC) project team and the Geisinger Health System for being such great collaborators on the Online Medication Feedback Pilot Study.

This article was originally published in the Health IT Buzz and is syndicated with permission.