How should electronic health records be designed? A cross-sectional study in patients with psoriasis

Abstract

BackgroundElectronic health records (EHRs) are promising tools for routine care. These applications might not only enhance the interaction between patient and physician but also support therapy management. This is crucial in complex and chronic conditions like psoriasis. However, EHRs can only unfold their full potential when being accepted by the users. Therefore, this study aims to analyse how EHRs should be designed for patients with psoriasis and to identify differences between patient subgroups.MethodsWe developed a questionnaire on the acceptability of EHRs based on literature research and results from focus groups. Participants completed a paper-based or electronic version of the questionnaire. We recruited participants at an outpatient clinic as well as online via patient associations and a social media platform. We analysed data using descriptive statistics and bivariate analyses applying Chi-square and Fisher’s exact test.ResultsThe sample encompassed 187 patients with psoriasis. Data reveals that 84.4% of the participants can think of entering data into an EHR. Participants prefer entering data at home (72.2%) instead of entering data in the waiting room (44.9%) and using an own internet-ready device (laptop/computer: 62.6%; smartphone/tablet: 61.5%) instead of a provided device (46.0%). Altogether, 55.6% of participants would accept entering data on a monthly basis when this lasts between one and 10 minutes and further 27.8% would accept even longer lasting data entry. Data privacy is of great concern (e.g. patient should decide who has access to data: 96.7%). Subgroup analyses reveal differences with regard to age, educational level, burden due to psoriasis, number of internet activities, use of electronic questionnaires and mode of administration.ConclusionThe high acceptance of entering data is favourable for the implementation of EHRs. The results suggest technical and structural recommendations: Differences between subgroups support the development of flexible EHRs encompassing a basic module, which is expandable with further add-ons, and compatible to different devices. Furthermore, involving patients by entering data into an EHR requires that physicians communicate open-mindedly with the patient and consider data throughout decision-making. Patients should remain owner of their own health data and decide about its processing.

Effect of PreAnaesThesia Computerized Health (PATCH) Assessment on Duration of Nurse—Patient Consultation and Patient Experience: A Pilot Trial

“…Although the National Electronic Health Records (NEHR) in Singapore does not currently allow patients to contribute directly to their electronic health records, patients have contributed to their electronic health records in other settings [ 34 ]. A recent study in patients with psoriasis reported a high acceptance rate (84%) for patients to enter data directly into an EHR and from home (72.2%) [ 35 ]. The study team is currently working with the hospital’s medical informatics department to explore this initiative.…”

Attitudes towards using electronic health records of patients with psoriasis and dermatologists: a cross-sectional study

“…Moreover, this article disregards aspects of data privacy, which is a frequently expressed issue [ 2 , 35 ]. Results on data privacy from this study were excluded from this article but have been published elsewhere [ 22 ]. These results [ 22 ] underline that patients demand to know where and how data are stored as well as who has access to it.…”

“…Results on data privacy from this study were excluded from this article but have been published elsewhere [ 22 ]. These results [ 22 ] underline that patients demand to know where and how data are stored as well as who has access to it. Nevertheless, other studies indicate that concerns about data privacy might decrease when frequently using EHRs [ 25 ] and that patients’ enthusiasm might outweigh their concerns [ 36 ].…”

“…Development of the questionnaire was based on literature research and on results from previously conducted focus groups with patients with psoriasis (described in more detail in [ 22 ]). Patient questions were developed at first and later adapted for the physician questionnaire accordingly (e.g.…”

“…Analyses include items that were posed to patients and physicians as well as items that were exclusively posed to one group. The questionnaires encompassed further items, which are not part of this article and will be published elsewhere [ 22 ].…”