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Paper records more secure: survey

A plurality of people in a recent survey indicated paper-based medical-records systems are more secure than electronic records, but under emergency circumstances, a large majority also indicated the rewards of having their medical records made electric outweigh the risks, according to a survey released today by Kaiser Permanente.

The Oakland, Calif.-based integrated delivery system sponsored the random, national telephone survey of 1,000 adult U.S. residents by StrategyOne, a unit of the Edelman public relations firm. Kaiser, which is undertaking an overbudget and overdue multibillion-dollar healthcare information technology rollout, is hosting a healthcare IT conference today in Washington.

According to the survey, when asked which form of record system was more efficient, 72% of respondents chose computer-based compared with 19% for paper-based, with 8% answering they were unsure. But when asked which type of medical records system was more secure, 47% chose paper, 42% computerized, and 10% were unsure. (Some numbers do not add up to 100% due to rounding.)

Survey participants also were asked whether they agree or disagree with the following statement: "The benefits of electronic medical records, such as better treatment in an emergency and a reduction in medical errors outweigh any potential risk to patient privacy or the security of patient information." Their answers: 21% indicated they strongly agree, 52% somewhat agree, 16% somewhat disagree, 9% strongly disagree and 2% indicated they didnít know or were unsure.

Participants also indicated, when it came to choosing between a physician or an insurance plan, all other things being equal, they expressed a strong preference for physicians (51%) and insurers (68%) that use electronic health-record systems over those who/that did not, (17%) and (16%), respectively.

They also expressed a slight preference for using an insurance company Web site to learn more about their healthcare coverage or to check on the status of a claim, 56% who expressed some interest vs. 43% were not very interested or not at all interested.

But in results that may present a challenge to payers offering or planning to offer personal health records for their members, survey participants were split almost evenly on their use. Asked if they were interested in using an insurance company-sponsored Web site to review personal medical records, such as past treatment, medications and test results, 23% indicated they were very interested, 28% somewhat interested, 16% not very interested, 32% not at all interested and 1% were unsure.

And while 46% of respondents indicated they have used Web sites to look up information regarding a health concern, 57% also indicated that before taking this survey, they had not seen, read or heard anything about electronic medical records. Surprisingly, 57% responded that their primary-care physician uses a computer record system, although the term was not clearly defined in the question. That is a percentage more than double the EHR penetration rate for office-based physicians in large groups, and more than quadruple the rate of physicians in small groups, according to a 2005 survey by the Medical Group Management Association, one of the more comprehensive surveys of physician IT usage.

"We think that more visibility for healthcare IT is important," said physician-informaticist Louise Liang, a senior vice president of quality and clinical systems support at Kaiser Permanente. "We believe it will improve cost and quality. It is expensive. And right now we don't have incentives for institutions to adopt IT."

Liang said one reason Kaiser conducted the survey was to increase patient awareness of healthcare IT, and create "more of a pull" for IT than a push.

"There are some significant, ongoing concerns about security," Liang said. "There is an understanding that there is a value that, for most people, overcomes that concern. This data we found very positive; when the final choice comes, there is enough value that it would be a significant factor in choosing their healthcare providers or their healthcare insurers."

Liang attributed survey respondents reporting unusually high EHR usage rates for their physicians to the way the question was asked. "We weren't very specific about what an electronic medical record is," Liang said. "We know the electronic medical record as a term means a lot of different things to different people. This survey did not explore that."

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