Relatively little is known about patients’ preferences and reactions with regard to having access to their records, but studies have generally shown positive results. Michael and Bordley (1982) found that a majority of patients they surveyed desired access to their medical records. Other studies have revealed that patients appreciate being given all details or a summary of their care (Bronson et al., 1986; Giglio et al., 1978; Gittens, 1986). For example, a pilot study of shared records for people with mental illness revealed enthusiastic acceptance by both patients and health staff (Essex et al., 1990).

Little is known about the extent to which patients understand the information in their medical records. In one study, chronically ill patients who had access to their records reported understanding about half or more of the information they contained (Gittens, 1986). In a study of stroke patients, those having access to their complete medical record reported understanding more about their condition than did control patients who had been given only relevant descriptive medical information (Banet and Felchlia, 1997).

There is some evidence indicating that giving patients greater access to clinical information and their own personal health information improves the process of care and health outcomes:

• Smokers who had access to their medical records were more likely to state that smoking was a major health concern than were control patients who did not have such access. After 6 months, significantly more patients in the former group had quit smoking (65 percent) compared with those in the latter (29 percent) (Bronson and O’Meara, 1986).

• College students who were given information from their medical record were more likely than controls to increase their adherence to treatment advice (Giglio et al., 1978).

• Elderly patients whose medical records were shared with them were more likely to know their medical problems and treatments (although not more likely to adhere to medication regimens) (Bronson et al., 1986).

• In Australia, Liaw et al. (1998) gave a small set of patients with chronic problems (29 experimental and 22 controls) a computer-generated health record. They found that doing so was practical and well received, and led to positive trends in improved awareness of issues, health promotion, and disease management.

• Patients with chronic medical conditions who received copies of the progress notes in their medical records reported significant increases in overall physical function and overall health status, greater satisfaction with their care, and more interest in seeing their medical records than patients in a control group who did not receive this information (Maly et al., 1999).

• In a randomized controlled trial of women attending an antenatal clinic, those given their entire record (experimental group) as opposed to a summary