Four ways to decrease withholding of information from electronic health records

An interesting piece of research was recently published in the Journal of the American Medical Informatics Association (JAMIA) – abstract here. Of interest is the fact that 13% of patients self reported that they have withheld information from a provider because of privacy security concerns. The research further suggests that this withholding of information may be (at least in part) driven by the providers’ use of electronic medical or health records.

This is deeply ironic as electronic records’ biggest advantage is continuity of data and information. Moving towards as complete as possible record held in one place should prevent duplication and waste, give the clinician a more complete picture of the patient and their history, and contribute towards early detection of problems by detecting trends in data that might otherwise be stored on disparate systems. Is all of this negated by the 13% who withhold some information? To an extent, yes. However it is not a fatal flaw and there are things that can be done to drive the extent of withheld information down:

1. Give patients real and tangible control over their records. This includes the ability to add and delete information from the record. The deletion includes information that may have been put there by a clinician. It also includes control over who sees their record or not, for example patients should be empowered to determine which clinician is able to see their records, whether or not a particular clinician has contributed to a record or not.
2. Often the long term benefit of an electronic record is not immediately apparent or felt by a patient. Allow patients to do things with their records that give them some immediate value – like being able to share aspects of their record online, discuss things with others like them (and other healthcare providers), and engage them in meaningful, entertaining, and fun ways.
3. Provide automated (but meaningful and useful) feedback on any and all aspects of the record that the patient desires, or shows an interest in.
4. Constantly research and improve ways of enhancing privacy and security, and let the patient know what you are doing.