Perceptions of Electronic Health Records and Their Effect on the Quality of Care: Results from a Survey of Patients in Four States

Introduction. As federal resources are invested into wider adoption of electronic health records (EHRs) in primary care practices, it is important to understand patients’ perceptions of EHRs, including their effect on the patient-provider relationship, quality of care, and views toward data security and confidentiality. Methods. A survey instrument was developed and administered to adult patients immediately following a provider visit. Descriptive and regression survey analyses compared outcomes of patients served by EHR adopter and non-adopter practices and those served by recent and early adopters. A survey of 670 patients with a patient-level response rate of 53 percent within the 37 participating practices was conducted from November 2010 to April 2011. Results. Patients had favorable perceptions of EHRs. Most believed that EHRs improved the quality of care and most were not concerned with confidentiality of records. Adopters’ patients rated the quality of care higher than non-adopters’ patients. Survey results showed no detrimental effect of EHR use on patient-provider communication and no relationship between the way in which physicians interacted with the computer and patients’ perceptions of care. Transition issues did not affect patient satisfaction. This is a cross-sectional study, this survey was not nationally representative; the participation rate of practices was low and the power was somewhat low. Discussion. Policymakers and providers need not be concerned that EHRs will harm the patient-provider relationship, which is encouraging for policies promoting adoption. Because this study was conducted shortly after the EHR Incentive Programs began, it is important to continue to closely monitor the unintended consequences of providers’ use of EHRs on the patient-provider relationship. Mathematica Policy Research 1