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Debate continues over how to present medical records to patients


As patient access to electronic medical records takes shape, many questions remain.

As patient access to electronic medical records takes shape, many questions remain. Should patients see their entire medical records? Or should the records be repackaged to make them easier to understand and not needlessly upset patients?

Information on patient medical records answer the “how” and “what,” but not the “why.” Abnormal test results, for instance, may be expected for certain patients and not be cause for alarm. However, a patient seeing they are far out of the average range could be unduly concerned if the information is not presented in context.

“From an Health Care Service Corporation (HSCS) perspective, our members can never have too much information,” says Paul Handel, M.D., HCSC’s chief medical officer. “ We encourage our members to get as much information about their health as possible. Being informed enables them to make the best decisions about their health once their doctors present them with options for care.”

Handle says doctors can head off potential medical record confusion by telling their patients why they order a test as well as its possible results.

“A major benefit of connectivity is the ability to educate, raise awareness and have patients more engaged in their health care decisions and choices,” he says.

According to a recent article in the Huffington Post, Kaiser Permanente, which has been sharing medical records to patients since 2004, is removing warning flags from some lab result tests and replacing them with a normal range and patient value. The health plan says the flags were a concern for some members. Intermountain Health Care in Utah also removes warning flags.

“The only way insurers should repackage personal health records or online test results is to make them easier for members to understand,” says Handel. “Typically test results are provided to doctors with scientific details that enable them to better understand their patient’s condition. Without medical training, the average person could misinterpret this data. For example, a member would need to know that ‘malignant’ is a serious term if it appears on their record.”

He says HCSC is getting ready to deploy new personal health records that will help doctors communicate with their patients in a more understandable way.

One such way, according to the Huffington Post, comes from Harvard–affiliated Beth Israel Deaconess Medical Center in Boston where it shows average ranges, abnormal ranges and warning flags on test results. It also includes links to educational materials to help patients understand the results.

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