The use of personal health records by veterans remains low, paralleling the experience of the private healthcare sector. Only 30% of veterans had registered for the VA's patient portal and only 17% had authenticated their identity, giving them access to their health data and other functions as of April 2012, according to the study, published Dec. 12 in the Journal of Medical Internet Research.
Only 11.06% of veterans refilled prescriptions through the portal, and 1.91% used secure messaging to communicate through their providers, found the study which examined records of the 6.01 million veterans served by the system.
The VA's experience parallels that of the private sector, which has found it difficult to get patients to engage with their online portals, which offer functions such as secure messaging and online data access.
According to separate information released by the CMS Nov. 4, early second-stage meaningful-use attesters have particular difficulty with the view, download, and transmit capabilities that correspond to patient access to their own data. The second stage of the meaningful use program required that at least 5% of patients access their data. Many hospitals just scraped by, with 86% of attesters having fewer than 20% of patients accessing their data.
Patients of eligible medical professionals performed better; only 28% of those professionals had fewer than 20% of patients access their own data.
While the overall picture is not encouraging, the Journal study hints at one possibility that might drive engagement. Patients with certain conditions, it notes, are much more likely to use the systems' online tools. Younger, more affluent users are more likely to use the internet, so the study adjusts for that.
Post-adjustment, patients with depression, HIV and spinal-cord injury are more likely to authenticate than average. Particularly interesting were rates of adoption of secure messaging for patients with depression and mental illness—they were far more likely to use secure messaging, even though the system only turned on that function for patients with mental illnesses relatively late in the study.
The study speculates that the reason for variable rates of adoption among patients with certain conditions may be the frequency of going to a hospital, and the need to track certain laboratory or vital signs readings. These patients, the study suggests, may get more use out of the system.
Also, the study argues, the interface of the VA's system may be more user-friendly for patients with certain conditions, meaning that providers may have to consider how to individualize online tools if they're interested in getting patients to use them.
Follow Darius Tahir on Twitter: @dariustahir