Despite the increasing push for electronic record-keeping in the medical community, a recent poll by Harris Interactive (Rochester, New York) has found that most people have not read or heard anything about electronic medical records (EMRs).

And while the potential benefits of EMRs sound appealing to most of the people surveyed, many are concerned about issues of privacy with such systems.

These are some of the findings of three different surveys, each containing questions about EMRs, conducted by Harris in 2006 and 2005. Two of these surveys were conducted with Alan Westin, PhD, professor of public law and government emeritus at Columbia University (New York), a leading authority on privacy issues in healthcare and other business and government settings, according to Harris Interactive.

In reviewing the survey results, Westin said, "Personal medical records have always been rated as highly sensitive by the American public. As programs to automate and interconnect patient medical records across the U.S. healthcare system proceed, it will be vital to track how patients see this affecting not only the quality and costs of healthcare, but also the confidentiality, privacy and security of their personal health information."

According to Harris Interactive, many people know virtually nothing about the current campaign to adopt EMRs throughout the U.S. Only 29% of those surveyed claim to have read or heard anything about them.

Therefore, the company points out, mass public opinion about EMRs does not yet exist. How public opinion develops, as public knowledge and awareness of EMR grows, will depend on reports in the media on the advantages and disadvantages they offer, it said.

However, even though most of those surveyed knew little or nothing about EMR system developments, many found the potential benefits of EMRs appealing, according to the survey results.

• A majority of respondents said they agreed with statements that EMRs hold out the promise of significantly decreasing medical errors (55%); significantly decreasing healthcare costs (60%); and improving the quality of care by reducing unnecessary test and procedures (68%).
• A majority — 62% — also agreed with the suggestion that adoption of EMRs will make it "more difficult to ensure patients' privacy."
• While few survey respondents — 4% of all adults or less — said they currently use services to be provided by health information technology, substantial majorities of the respondents said they would like to be able to: receive reminders to revisit their doctors online (77%); communicate with their doctors by e-mail (74%); schedule appointments online (75%); receive the results of diagnostic tests via e-mail (67%); use home monitoring devices, like blood pressure readings or blood tests, and send results to their doctors' offices by telephone or e-mail (57%).
• Overall, a 64% majority said, when asked, that they would like to have "an electronic medical record to capture medical information."
• And, when asked how they feel about the risks that EMRS will compromise privacy, 42% of respondents said the privacy risks outweigh expected benefits while 29% said the expected benefits outweigh potential risks and another 29% of respondents were not sure.

Harris also surveyed respondents on their desire for personal involvement when organizations providing them with health care transition to EMRS.

When presented with a list of four choices as to how they might be notified or consulted about the transition from paper records to EMRs, there was "absolutely no consensus," Harris Interactive said.

• About one in five respondents (21%) said they want to be given the right not to have their medical records entered into the new electronic systems.
• Just over a quarter (27%) said they want to be notified but would probably "be okay" with this.
• Another 12% said they would want to be able to designate what does or does not get entered in their EMRs.
• And only 22% say that they would not need to be notified.
• Still, 17% said they were not sure.

"What this indicates," Westin said, "is that over three quarters of the public — 78% — do not believe that organizations moving into an EMR system should treat this as just a clerical or administrative change. Rather, the public wants affected patients to be informed of how [this] step would affect the handling of their health information and to be given various kinds of choices in the process."

Replies to two other questions, asked in the 2005 survey, suggest that the HIPAA rules have been somewhat successful in retaining public confidence and reassuring patients that their medical privacy is being protected.

• Two-thirds of respondents (67%) said they remember receiving HIPAA notices from their providers or insurer
• And a majority of those who recalled this said that the regulations and the privacy notices have increased their confidence either somewhat (44%) or a lot (23%).

This suggests that notification to patients of the transition to EMRs, explanations of their effects and communication of continued HIPAA privacy rights would help reassure the public that their privacy will not be put at risk by EMRs, according to Harris.

The Harris poll conducted three different surveys each of which contained some relevant questions on EMRs in 2006 and 2005. Two of these surveys (Sept. 7-13, 2006 and Feb. 8-13, 2005) were conducted with Westin. The third survey (Sept. 5-7, 2006) was conducted with The Wall Street Journal Online.

The surveys were filed Sept. 7-13, 2006 (among a national online sample of 2,747 adults), Sept. 5-7, 2006 (among a national online sample of 2,624 adults) and Feb. 8-13, 2005 (among a national sample of 1,012 adults.)

According to the company, data for age, gender, race, education, region and household income were weighted where necessary to bring them into line with actual proportions in the population.

Harris said that all of the surveys are subject to sampling error because only a sample of a population is interviewed, measurement error due to question wording and/or question order, deliberately or unintentionally inaccurate responses, no response (including refusals), interviewer effects (when live interviewers are used) and weighting.