Numerous programs exist to offer the patient access to their electronic medication record (EMR) via the Internet. In Ontario and the rest of Canada, similar projects are in progress, such as the electronic health record for patients at the Ontario HIV Treatment Centre and Princess Margaret Hospital, the electronic children's health network (ECHN) that links children's hospitals in Ontario and the development of a pan-Canadian record by the Canada Health Infoway. The purpose of this research was to evaluate the patient and physician experiences of using SPARRO (System Providing Patients Access to Records Online), a patient-accessible EMR. The patients perceived an improved effect on their chronic disease management with the patient-accessible EMR, and physicians became more supportive of the system since none of their initial concerns were realized during the study.

Background: Numerous programs exist to offer patients access to their electronic medication record (EMR) via the Internet. However, physicians expressed some concerns with the patient-accessible EMR, such as patients bypassing them for information, increased medical errors, increased workload with questions from patients on the system, and documentation of sensitive information. In Ontario and the rest of Canada, similar projects are in progress, such as the electronic health record for patients at the Ontario HIV Treatment Centre and Princess Margaret Hospital, the electronic children's health network (ECHN) that links children's hospitals in Ontario and the development of a pan-Canadian record by the Canada Health Infoway.

The research objective was to evaluate the patient and physician experiences of using SPARRO (System Providing Patients Access to Records Online), a patient-accessible EMR. SPARRO is a secure web-based application made up of three components: 1) the medical record; 2) a guide to heart failure; and 3) a messaging system.

Methods: In the randomized control trial, the intervention group (i.e., 54 patients with congestive heart failure) was provided access to SPARRO and a manual to the system, while the controls (i.e., 53 patients with congestive heart failure) received the usual care. Eight physicians participated in the study. Patients and physicians completed separate questionnaires before and after the trial period in order to assess their expectations of potential benefits and risks associated with SPARRO.

Findings: The intervention group felt that SPARRO had a positive effect on their chronic disease management. Yet, some patients had difficulty understanding the medical jargon. Patients also perceived the potential benefits of SPARRO to be: 1) learning more about their medical condition; 2) coordinating care; 3) learning about medical decision making; 4) reinforcing their memory regarding instructions or information from the visit; 5) increasing their participation in their care; 6) streamlining certain processes; and 7) confirming normal results and the accuracy of the medical record. Physicians became more supportive of the patient-accessible EMR since none of their initial concerns materialized during the trial.

Conclusions: With technology constantly evolving, there will be more interest in providing patients access to the medical records online. Nonetheless, the patient-accessible EMR requires further enhancements in order to maximize the potential for increased patient-centered care.

Reference: Earnest, MA, Ross, SE, Wittevrongel, L, Moore, LA, Lin, C. "Use of a Patient-Accessible Electronic Medical Record in a Practice for Congestive Heart Failure: Patient and Physician Experiences." Journal of the American Medical Infomatics Association, 2004, 11(5): 410-417.

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