Patient EMR Access May Be The Biggest Cultural Shift

Posted on April 15, 2013 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or

As most readers probably know, U.S. doctors are skittish about giving patients full access to their medical records. That fact was underscored by a recent Accenture study, which concluded that 65 percent of doctors think patients should only have limited access, and 4 percent feel patients should have no access.

While I have no proof of this, my gut feeling is that these results aren’t just a snapshot in time, but rather a sign of a stubborn problem that’s not likely to melt away quickly. Though much of the high-level thinking about EMRs counts on building collaborative patient relationships over shared records, that thinking may be flawed.

Why are doctors hanging back from full and free disclosure of electronic health data?

Self-consciousness:  Doctors may say things in records that they’d be a bit embarrassed to reveal. To some extent, this is a problem whether the doc is  using paper or an EMR, but EMRs are trickier for doctors to use, adding to the awkwardness factor if a patient questions their work or feels offended by the commentary.

Poor collaboration skills:  If patients get to see their records, they’re likely to become all e-patient-ish and want to have more control of their care.  Old-school doctors aren’t trained to think this way, nor are they likely to want such a relationship temperamentally.

Low digital comfort generally:  Even among younger physicians, there are those that are naturally wired and those that only use computing devices when they must. I’d argue that when you toss in the generation of doctors who trained 100 percent on paper, you’re looking at a large population of physicians who may never quite be on board with touchy-feely data sharing.

Bottom line, data sharing with patients requires a cultural shift which a surprising number of healthcare pros seem ill-equipped to embrace.  I believe it is this cultural shift — from patient as object of notes to patient as co-creator — which will ultimately pose the biggest obstacles to getting value from EMR investments.

Yes, it’d be nice to think that as doctors get more used to living with EMRs, a large number will loosen up, but I doubt that’s the case. Let’s hope the cynic in me is wrong this time.