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Patients' e-records access tied with increased healthcare use: study


By Joseph Conn
Posted: November 20, 2012 - 5:00 pm ET
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A study of patients at Kaiser Permanente in Colorado found that patient use of Web-based electronic health-record system portals was linked to an increased use of clinical services, including higher rates of office visits and telephone calls to providers.

Results of the study are set to be published in an article, "Patients with Online Access to Clinicians, Medical Records Have Increased Use of Clinical Services," in the Nov. 21 issue of the Journal of the American Medical Association.

The study looked at healthcare services by nearly 89,000 patients enrolled for at least 24 months with the integrated delivery network from March 2005 through June 2010. These patients were divided into two equal groups: those who were users of the organization's My Health Management patient online access system and those who were not. Researchers found "a significant increase in the per-member rates of office visits (0.7 per member per year) and telephone encounters (0.3 per member per year) for portal users compared with nonusers," according to a news release about the study.

"There was also a significant increase in per-1,000-member rates of after-hours clinic visits (18.7 per 1,000 members per year), emergency department encounters (11.2 per 1,000 members per year) and hospitalizations (19.9 per 1,000 members per year) for MHM users compared with nonusers," the release stated.

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Researchers have several theories about why the portal-linked increases in care use occurred. For example, additional health issues may have been identified through use of the portal, prompting patients to make more visits and phone calls. In addition, patients may have activated their portals "in anticipation of health needs," and those individuals already more likely to use healthcare services may have been more likely to sign up to use the portal, the summary said.

"If these findings are evident in other systems, healthcare delivery planners and administrators will need to consider how to allocate resources to deal with increased use of clinical services," the authors said. "As online applications become more widespread, healthcare delivery systems will need to develop methodologies that effectively integrate health information technologies with in-person care."


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