Freise Lisa, Neves Ana Luisa, Flott Kelsey, Harrison Paul, Kelly John, Darzi Ara, Mayer Erik K
Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, United Kingdom.
Center for Health Technology and Services Research / Department of Community Medicine, Health Information and Decision (CINTESIS/MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.
JMIR Form Res. 2021 Feb 26;5(2):e19074. doi: 10.2196/19074.
Sharing personal health information positively impacts quality of care across several domains, and particularly, safety and patient-centeredness. Patients may identify and flag up inconsistencies in their electronic health records (EHRs), leading to improved information quality and patient safety. However, in order to identify potential errors, patients need to be able to understand the information contained in their EHRs.
The aim of this study was to assess patients' perceptions of their ability to understand the information contained in their EHRs and to analyze the main barriers to their understanding. Additionally, the main types of patient-reported errors were characterized.
A cross-sectional web-based survey was undertaken between March 2017 and September 2017. A total of 682 registered users of the Care Information Exchange, a patient portal, with at least one access during the time of the study were invited to complete the survey containing both structured (multiple choice) and unstructured (free text) questions. The survey contained questions on patients' perceived ability to understand their EHR information and therefore, to identify errors. Free-text questions allowed respondents to expand on the reasoning for their structured responses and provide more detail about their perceptions of EHRs and identifying errors within them. Qualitative data were systematically reviewed by 2 independent researchers using the framework analysis method in order to identify emerging themes.
A total of 210 responses were obtained. The majority of the responses (123/210, 58.6%) reported understanding of the information. The main barriers identified were information-related (medical terminology and knowledge and interpretation of test results) and technology-related (user-friendliness of the portal, information display). Inconsistencies relating to incomplete and incorrect information were reported in 12.4% (26/210) of the responses.
While the majority of the responses affirmed the understanding of the information contained within the EHRs, both technology and information-based barriers persist. There is a potential to improve the system design to better support opportunities for patients to identify errors. This is with the aim of improving the accuracy, quality, and timeliness of the information held in the EHRs and a mechanism to further engage patients in their health care.
共享个人健康信息对多个领域的医疗质量有积极影响，尤其是在安全性和以患者为中心方面。患者可能会识别并标记出其电子健康记录（EHR）中的不一致之处，从而提高信息质量和患者安全。然而，为了识别潜在错误，患者需要能够理解其EHR中包含的信息。
本研究的目的是评估患者对自己理解EHR中所含信息能力的看法，并分析理解这些信息的主要障碍。此外，还对患者报告的主要错误类型进行了特征描述。
2017年3月至2017年9月期间进行了一项基于网络的横断面调查。共有682名护理信息交换（一个患者门户网站）的注册用户被邀请完成该调查，这些用户在研究期间至少有一次访问记录。该调查包含结构化（多项选择）和非结构化（自由文本）问题。调查包含有关患者对理解其EHR信息从而识别错误的感知能力的问题。自由文本问题允许受访者详细阐述其结构化回答的理由，并提供更多关于他们对EHR的看法以及识别其中错误的细节。2名独立研究人员使用框架分析方法对定性数据进行了系统审查，以识别新出现的主题。
共获得210份回复。大多数回复（123/210，58.6%）表示理解这些信息。识别出的主要障碍与信息相关（医学术语、知识以及检查结果的解读）和技术相关（门户网站的用户友好性、信息显示）。12.4%（26/210）的回复报告了与信息不完整和不正确相关的不一致情况。
虽然大多数回复确认理解了EHR中包含的信息，但技术和基于信息的障碍仍然存在。改进系统设计以更好地支持患者识别错误的机会具有潜力。这旨在提高EHR中所存信息的准确性、质量和及时性，并建立一种机制，使患者能进一步参与自身医疗保健。
