Digitalchart

IOWA CITY - Living with a rare medical condition that causes her hands, face and even windpipe to swell has cluttered Maureen Picciallo's days with calls to doctor's offices and tedious recording of her symptoms.

Until last summer.

That's when University of Iowa Hospitals and Clinics - where Picciallo receives care for her hereditary angioedema - introduced MyChart, a web-based system giving patients full online access to their medical records. The password-protected system lets patients log on via computer or smartphone and view test results, read physician notes, request prescription renewals, make appointments, send messages to doctors and review instructions - without making a call.

“This has given me more independence,” said Picciallo, 34, of Bettendorf, who previously called her doctor to report possible swelling and now just sends a message through MyChart and continues with her day.

The convenience of MyChart and the control it gives patients over their health care is why UIHC officials say 39,051 people have signed up to use the system, which was launched as a pilot in July 2010 and made fully live in March. In April, the hospitals enabled iPhone users to browse their medical records on their cellphones, and Android users gained access on Oct. 31.

MyChart debuted with a fair share of debate and controversy, though. Compared with other hospitals using MyChart or a similar program, Iowa releases more information than most, said Brian Denning, assistant director of clinical applications.

“A lot of places selectively release information; they don't release all the lab results,” Denning said. “We are releasing everything. That includes your cancer results.”

UIHC posts all test results on MyChart after a doctor reviews them or, at the latest, four days after their release - regardless of whether a doctor has talked with the patient. Denning said some officials and physicians were worried users might misinterpret the results.

“People have been nervous about that,” he said, “but our doctors do have the opportunity to talk to patients. The doctor has four days to communicate with the patient if there is a desire or need to communicate before it automatically ends up on MyChart.”

Douglas Van Daele, chief medical information officer, said he long has pushed to give patients more access to their medical records, even though some of his colleagues have what he calls “MyChartaphobia.”

“Our providers are anxious about it, and it does perhaps raise their blood pressure and give them reflux,” Van Daele said, “but even though that was a huge concern before implementing it, it has not been such a big concern after.”

Most of the patients who use MyChart are savvy enough to check with doctors before making assumptions, Van Daele said. The hospital has received positive feedback from the majority of patient users who appreciate fast access to test results.

“And they just love to have the ability to go back in and look at what was documented,” he said. “It's helpful for patients to have more interaction with their own health statuses.”

Kathryn Gohman, owner of the Dallas-based Patient Advocate Group, said she's worried that users might misinterpret information and that, should the system falter, wrong information will end up in someone's online chart.

“I have concerns because there are so many mistakes,” Gohman said. “We don't want someone having a heart attack because they got the wrong information.”

Allina Hospitals and Clinics, a system of 11 hospitals and 60 clinics in Minnesota, posts tests results online automatically within four days of their release - like UIHC. They have different rules for tests deemed “highly sensitive,” like STDs, cancer markers and fetal screenings.

Scott McIntyre, communications director for the Iowa Hospital Association, said his organization is encouraged by UIHC's leadership in medical record advancements - despite the concerns.

“It's heartening to see them as one of the institutions taking a leadership role in advancing innovations,” McIntyre said.

UIHC has more in its innovation hopper. Patients soon will be able to fill out pre-appointment forms online before they arrive, and patients who regularly record health activity - like diabetes patients taking blood sugar tests - soon will be able to do so through a MyChart feature that shares results with a doctor.