People who had access to their medical records online also came into their doctor's office for more appointments and used the emergency room more often than those who didn't log on, according to a US study. That contradicts one theory supporting online access to health records, which says that if patients can look up their test results and put in for prescription refills online, they'll make fewer unnecessary trips or calls to the office, saving both time and money.
The new report, which appeared in the Journal of the American Medical Association, questions whether online records always make care more efficient. "I strongly believe that patients are going to find this very helpful and that it will be possible to use the personal health record in ways that do improve efficiency," said David Bates, from Brigham and Women's Hospital in Boston, who co-wrote an editorial accompanying the study.
Researchers from Kaiser Permanente Colorado in Denver compared 44,321 health plan members who had access to their medical records and could email their doctors to an equal number who didn't use the online system. The patients in each group were matched for age, gender, race and chronic diseases. The researchers found that patient visits and calls tended to go up in the year after people started using the electronic records. But for those in the no-access group, measures of health care use typically declined or stayed constant compared to the year before.
Online users went to the doctor's office an average 0.7 extra times each over the year and called an extra 0.3 times each, versus non-users. Their rate of after-hours clinic visits, ER trips and hospitalisations also rose in comparison, by an extra 11 to 20 visits and stays for every 1,000 patients a year.
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