Department of Psychology, Health & Technology, University of Twente, Citadel H423, P. O. Box 217, 7500 AE Enschede, The Netherlands.
Rheumatol Int. 2013 Sep;33(9):2405-10. doi: 10.1007/s00296-012-2408-2. Epub 2012 Mar 28.
Technology enables patients home access to their electronic medical record (EMR), via a patient portal. This study aims to analyse (dis)advantages, preconditions and suitable content for this service, according to rheumatology health professionals. A two-phase policy Delphi study was conducted. First, interviews were performed with nurses/nurse practitioners (n = 9) and rheumatologists (n = 13). Subsequently, collected responses were quantified, using a questionnaire among the interviewees. The following advantages of patient home access to the EMR were reported: (1) enhancement of patient participation in treatment, (2) increased knowledge and self-management, (3) improved patient-provider interaction, (4) increased patient safety, and (5) better communication with others. Foreseen disadvantages of the service included: (1) problems with interpretation of data, (2) extra workload, (3) a change in consultation content, and (4) disturbing the patient-provider interaction. Also, the following preconditions emerged from the data: (1) optimal security, (2) no extra record, but a patient-accessible section, (3) no access to clinical notes, and (4) a lag time on the release of lab data. Most respondents reported that data on diagnosis, medication, treatment plan and consultations could be released to patients. On releasing more complex data, such as bodily examinations, lab results and radiological images the opinions differed considerably. Providing patients home access to their medical record might be a valuable next step into patient empowerment and in service towards the patient, provided that security is optimal and content and presentation of data are carefully considered.
技术使患者能够通过患者门户在家访问其电子病历 (EMR)。本研究旨在根据风湿病健康专业人员分析这项服务的(不)优势、前提条件和适用内容。进行了两阶段政策 Delphi 研究。首先,对护士/执业护师(n=9)和风湿病医生(n=13)进行了访谈。随后,在受访者中使用问卷对收集到的回复进行量化。报告了患者在家访问 EMR 的以下优势:(1) 增强患者对治疗的参与度,(2) 增加知识和自我管理,(3) 改善医患互动,(4) 提高患者安全性,以及 (5) 与他人更好地沟通。预计该服务存在以下缺点:(1) 数据解释问题,(2) 额外工作量,(3) 咨询内容变化,以及 (4) 干扰医患互动。此外,数据还显示了以下前提条件:(1) 最佳安全性,(2) 没有额外的记录,而是患者可访问的部分,(3) 无法访问临床记录,以及 (4) 实验室数据发布的延迟时间。大多数受访者报告说,可以向患者发布诊断、药物、治疗计划和咨询等数据。在发布更复杂的数据(如体检、实验室结果和影像学图像)时,意见差异很大。为患者提供在家访问其病历的权限可能是患者赋权和面向患者服务的有价值的下一步,前提是安全性最佳,并且数据的内容和呈现经过仔细考虑。