How Patients Can Improve the Accuracy of their Medical Records
Authors: Dullabh Prashila , Sondheimer Norman , Katsh Ethan , Evans Michael A. 
Published: October 2014

Objectives: Assess (1) if patients can improve their medical records’ accuracy if
effectively engaged using a networked Personal Health Record; (2) workflow efficiency
and reliability for receiving and processing patient feedback; and (3) patient
feedback’s impact on medical record accuracy.Background: Improving medical record’
accuracy and associated challenges have been documented extensively. Providing patients
with useful access to their records through information technology gives them new
opportunities to improve their records’ accuracy and completeness. A new approach
supporting online contributions to their medication lists by patients of Geisinger
Health Systems, an online patient-engagement advocate, revealed this can be done
successfully.In late 2011, Geisinger launched an online process for patients to provide
electronic feedback on their medication lists’ accuracy before a doctor visit. Patient
feedback was routed to a Geisinger pharmacist, who reviewed it and followed up with the
patient before changing the medication list shared by the patient and the
clinicians.Methods: The evaluation employed mixed methods and consisted of patient focus
groups (users, nonusers, and partial users of the feedback form), semi structured
interviews with providers and pharmacists, user observations with patients, and
quantitative analysis of patient feedback data and pharmacists’ medication
reconciliation logs.Findings/Discussion: (1) Patients were eager to provide feedback on
their medications and saw numerous advantages. Thirty percent of patient feedback forms
(457 of 1,500) were completed and submitted to Geisinger. Patients requested changes to
the shared medication lists in 89 percent of cases (369 of 414 forms). These included
frequency- or dosage changes to existing prescriptions and requests for new medications
(prescriptions and over-the counter). (2) Patients provided useful and accurate online
feedback. In a subsample of 107 forms, pharmacists responded positively to 68 percent of
patient requests for medication list changes. (3) Processing patient feedback will
requires both software algorithms and human interpretation. For the 107 forms subsample,
pharmacists accepted patient input in 51 percent of cases where they could not contact
the patient. Where the patient was contacted, they accepted feedback from 68 percent.
This suggests there may be opportunities to automate feedback filtering and processing
for more efficient (and larger scale) medication-list optimization. (4) A supportive
overall e-health environment makes acceptance of an online patient feedback system more
likely. Review of Geisinger usage data showed patients who completed the medication
feedback form had previously accessed MyGeisinger 2.3 times as often as the average
patient and initiated secure messages with a clinician 1.35 times as often as patients
not involved in the pilot.Conclusions: Patient feedback, placed in a useful workflow,
can improve medical record accuracy. Electronic health record (EHR) vendors and
developers need to build appropriate capabilities into applications. Continued research
and development is needed for enabling health care organizations to elicit and process
patient information most effectively.