Representative participant comments on functionality enhanced patient–clinician communication from using an interactive prevention health record (IPHR)
| Subthemes | Representative quotations |
|---|---|
| Interactive | Direct communications between the doctor and the patient that you can access via the Internet just like medical records, you should be able to access that. (As a result of using the IPHR) The nurse called me up and said we haven't seen you in so long, you know, and she starts going through this (prevention) stuff…I said well I've been going to my heart doctor…and she said, you should come back you know. Not dictating, but cooperating, supportive, and provide me the source of the information, let me go there and look at the thing (IPHR) before, you know we make a decision. |
| Focus discussion | I have 15 minutes to talk to him. And this gives me the ability to list everything that's wrong with me...This is what you need to talk to the doctor about in your physical. I would think anything that would focus my discussion would hopefully focus his as well. When I go in to the primary care physician, I don't want to just listen to him. I do want to hear what he has to say, but I want to be able to ask what I think are intelligent questions. I'll go do research on that. And then I feel like I can have a better, more productive discussion with the physician. |
| Broaden discussion | What if your doctor disagrees somewhat with the United States Preventive Services Task Force? (as recommended by the IPHR)...It becomes a discussion point. I think it (conversation with clinician) might be a little bit broader (from using the IPHR). You go and say, “Here's what I'm seeing or here's what going on with my family.” |
| Efficiency Pros and Cons | There might be an opportunity to take some of the minor issues off the table(after using the PHR), so when you go to the doctor it would shorten the amount of things that you would like to talk to him about because you've answered some of that already. That email to the doctor, I think, could create a problem. It's very time consuming. You spend all day on the internet answering mail, the doctor will never get paid…SECOND PARTICIPANT: You'd never get your tetanus shot. FIRST PARTICIPANT: ..You'd never get anything else. So what is this doing for the physician? I mean, we're keeping healthier, but it means a lot more work for him in a way. |
| Patient-centred IPHR utility | |
| Expand access to personal clinical information | It's not just security, but also access. My access to my personal information. I want to have that, and electronic medical records, Internet-based systems can provide me with that. I trust my physician here because I've developed a relationship with him, but anybody else, I would want to have absolute access to my information. |
| Align patient-clinician information | Knowing that all the information is correct to the best of your knowledge, and in one place where it can be accessed by the doctor and by you, it makes me feel very secure. This information is shared with your physician –– as you update things your provider is going to be made aware of this you know-We need to be on the same page. |
| Provide personalised information | I think with that information available (in the IPHR), I think it will actually help him a great deal to change my lifestyle. I think that's what all this preventive medicine is all about is how you change your lifestyle. It also gave me some thoughts about the preventive things I should need to know or that I should be thinking about. So it made me think about, gosh I'll have to ask her. For example, something about an aspirin a day, is it something that's appropriate for me? There was lots of information there but it was not, in my case not new information since my doctor and I had talked about it so much... |
| Comprehensively address patient needs | I'm surprised that this isn't something for medications. One doctor says you got to take calcium and another one says you got to take multivitamin and another one says you got to take an aspirin, and people may be taking allergy medicines that they get over the counter… Some general thing about menopause or some of the women's issues would have been helpful. Age specific things might be helpful, children, you know, developmental or something like that just as a good reference for parents. Say you had in your history that you had a history of stroke or cancer, would it also give patient education stuff, like here's a link to the American Cancer Society? Or here's a thing for support group information? I'm a surviving cancer patient… Here's what we want: we're living here but we want to occasionally go somewhere else. Anyone in the country should be able to open and keep track of it accurately…realistically and securely. |