Most fourth-year medical students at Northwestern track previous patients through electronic health records to confirm diagnoses and follow up on their patient’s progress, according to an article recently published in JAMA Internal Medicine.
Gregory Brisson, MD, ’94 GME, assistant professor of Clinical Medicine in the Division of General Internal Medicine and Geriatrics, and Patrick Tyler, ’14 MD, internal medicine resident at Beth Israel Deaconess Medical Center, conducted a survey of fourth-year medical students in Northwestern’s Class of 2014 to evaluate the prevalence of tracking former patients.
When third-year medical students in 2013, Tyler and his peers asked Brisson about the ethical issues surrounding the tracking of former patients. Not knowing what the correct answer was, Brisson encouraged the students to explore the topic along with him. After finding there was a lack of published research on the topic, Brisson and Tyler decided to investigate how many students follow up on patients using electronic health records in clinical clerkships.
According to the study, 96 percent of respondents use electronic health records to track former patients and of those who track former patients, 92 percent thought it benefited their education. A total of 103 out of 169 fourth-year medical students completed the survey.
The students surveyed had completed 48 weeks of clinical clerkships, which gave the investigators enough time to establish use of electronic health records. Reasons why students tracked patients included wanting to confirm diagnosis and follow up on pending studies, to follow a patient’s progress during treatments, or curiosity about the patient’s well-being. Through the survey, Brisson also learned that more than half of medical students learned to track patients on their own.
“We were both surprised at the results. We thought a fair number of medical students tracked patients, but were surprised that nearly all of them were,” said Brisson. “They were doing this in the absence of instruction; medical students wouldn’t do this if there wasn’t value to it. Now we are aware of this learning tool’s opportunity and could bring this into the curriculum.”
Seventeen percent of the respondents who tracked patients had ethical concerns about whether it was appropriate to access patient records if they are no longer part of the care team for those patients. Last year, Brisson and colleagues published an article discussing the ethical responsibilities of medical students tracking patients.
“This survey was done to raise awareness of the issue,” Brisson said. “The most important piece is that we are developing guidelines for medical students on how to use electronic health records to get educational benefits while maintaining patient privacy.”
This year, Brisson started testing the guidelines he has developed with third- and fourth-year medical students.
