Consumer awareness remains the biggest obstacle to the public's use of personal health records, according to a recently released survey, and a prominent health information technology executive said "healthcare provider engagement" is needed to remove this barrier.
Among the 440 health IT professionals responding to a Healthcare Information and Management Systems Society survey in November, 31% cited lack of consumer awareness as the largest obstacle to PHR use, followed by privacy concerns, 17%; cost and "Consumers don't think it is necessary," both at 13%; and security issues, 11%. Another 15% said "other" or "don't know." (Figures do not add up to 100% because of rounding.) See the full-sized chart here.
Edward Fotsch, M.D., chief executive officer of Medem, a San Francisco-based provider of physician-patient communication services including the iHealthRecord personal health record, said healthcare providers need to show their patients the benefits of using PHRs.
Physicians need to be engaged
Without the engagement of physicians and hospitals, he said consumers will not see the value of PHRs, won't trust that their medical information is secure, and won't be aware that such products even exist.
Of course, it still remains unclear what constitutes a PHR. The federal government's IT advisory group, known as the American Health Information Community or AHIC, stated that PHRs can be stand-alone platforms requiring manual input from paper charts or they can be integrated into the healthcare delivery system to automatically receive prescription information, lab test results or other personal medical data.
Fotsch said that "high on the list" of patient privacy concerns is that somehow their personal health information will be used against them by an employer. He said that's why Medem focuses on having iHealthRecord offered to patients by healthcare providers, but he added that the main promoters of PHRs are employers and health insurance plans -- two groups that do not enjoy the level of trust with consumers that doctors possess.
"The (survey) results are yet another indication that unless -- or until -- healthcare providers engage fully with their patients, the uptake is going to be dismal," Fotsch said. "Also, as a consumer, I'm told that I'm supposed to have a personal health record, but each time I go the doctor or the hospital, I have to fill out a blank clipboard. So what's the point?"
Until providers get their patients to recognize the value of PHRs as a reliable vehicle for sharing medical information, Fotsch said PHRs will be comparable to "nuclear-powered flea collars."
Some of the benefits
According to the survey, there is multifaceted value in PHRs, with 80% finding value in having anytime-anywhere access to healthcare information; 73% found value in being able to get test results on the Internet; 70% cited being able to check or refill prescriptions; 63% cited scheduling tests or appointments; 58% cited e-mails with their caregivers; 52% cited maintaining an immunization record; and 40% said they found value in being able to check for errors in their medical records.
Fotsch noted that the prescription, scheduling and messaging features that are valued by consumers are not of much use without provider participation.
Fotsch added that he was pleased that an early focus of AHIC has been promoting the elimination of clipboard registration through the use of PHRs or online registration.
So, while consumer awareness remains an obstacle, he said increasing national awareness of PHRs -- on the part of healthcare providers and government agencies -- should help spur their use.
"The real issue is 'Where is the awareness on the provider side?' And we see that growing tremendously," Fotsch said. "I think that's been the biggest breakthrough."
What do you think? Write us with your comments at [email protected].