The Urban Underserved

Electronic medical records (EMRs) are increasingly offered to patients, but little is understood about medically underserved patients or those with HIV/AIDS and their perception of EMRs. This study examines vulnerable patients’ attitudes toward online access to medical records, including doctors’ visit notes.

The Harborview Medical Center (HMC), managed by the University of Washington in Seattle, is a part of the OpenNotes project, providing a secure website portal allowing online EMR access for selected patients in the HIV clinic and the adult medicine clinic. Thirty HMC patients in four focus groups met in November and December 2009 to discuss EMRs. This qualitative study examined the transcripts of the focus group. Theme analysis was conducted using an immersion/crystallization approach.

Key Findings:

  • At baseline, patients’ understanding of health records and the EMR, was limited.
  • Patients believed online access would improve patient understanding of health and disease, be convenient, empower, and strengthen the provider/patient relationship.
  • Focus group participants were concerned about privacy and their ability to understand their record. They were concerned the computer may replace direct provider contact.

Focus group participants were positive about the electronic access to medical records, despite initial lack of knowledge. This study suggests that vulnerable patient groups may need targeted support in transitioning to EMRs.