Doctors may hold key to increasing adoption
Americans who have access to their health information through personal health records (PHRs) report that they know more about their health, ask more questions, and take better care of themselves than when their health information was less accessible to them in paper records, according to a ground-breaking study released by the California HealthCare Foundation (CHCF). The audio, slides and teleconference materials are posted below.
The survey indicates one in 14 Americans has used a personal health record, double the number of users from a year earlier. Users say that secure, password-protected PHRs give them the confidence they need to access their personal information online, and when they do, they pay more attention to their health. One in three PHR users say they used the PHR to take a specific action to improve their health – sparking hope that these technologies could be the long-awaited tools that help engage patients in taking better care of themselves. Surprisingly, the benefits of PHR use are most valued among populations that have been difficult for health care providers to engage: those with multiple chronic conditions, less education, and lower incomes.
“We know that most health care is self-care, since most people only see their physicians periodically,” said CHCF President and CEO Mark D. Smith, M.D. “This survey shows that when individuals have easy access to their health information, they pay greater attention to their health. And for the first time, the survey documents that PHRs empower some people – including some of the heaviest users of the health system – to take better care of themselves.”
Efforts to increase use of health information technology (IT) have received broad bipartisan support from federal lawmakers. The American Recovery and Reinvestment Act of 2009 included up to $29 billion to support providers adoption and meaningful use of electronic health records (EHRs). Government, businesses, and the health care sector see health IT as a way to improve quality and safety of care, better engage patients in their care, and ultimately make care delivery more efficient and less costly.
Despite the growing availability of PHRs through health plans and online services, the survey found most Americans have yet to take advantage of PHRs or related applications. While usage of these tools is relatively low, it has increased considerably from earlier surveys. In fact, 7 percent of Americans now say they have used a PHR – more than double the rate since 2008, when the Markle Foundation released a survey finding only 2.7 percent of people had used a PHR.
The survey also found that people prefer to use PHRs from their health care providers. About half of all survey respondents say they want to use PHRs provided by their physicians (58%) or insurers (50%). Just one in four (25%) reports wanting to use PHRs developed and marketed by private technology companies.
“The more successful the current federal effort is to promote EHR adoption among physicians and other providers, the easier it will be for patients to access their health information from their most trusted source,” said Dr. Smith.
Health care privacy remains a concern. In a 2005 CHCF national consumer survey, 67 percent of respondents said they were “very concerned” or “somewhat concerned” about the privacy of their health information; in 2010, 68 percent expressed the same levels of concern. Many of those surveyed expressed concern that their health information could be used by employers, health insurance plans, or others, and one third said they would consider hiding some information from their provider because of that fear. Still, two-thirds of those surveyed said privacy concerns should not stand in the way of learning how technology can help improve health care.
The survey of 1,849 people was conducted by Lake Research Partners between December 18, 2009 and January 15, 2010. Findings from the CHCF survey released today show.
Consumers become more engaged in taking action to improve their own health and health care when they access their medical information online.
- 56 percent of PHR users say they know more about their own health because they use these tools.
- 40 percent say they asked a question they wouldn’t otherwise have asked.
- 38 percent feel more connected to their doctors.
- 32 percent did something to improve their health.
PHR users are predominantly young, highly educated, higher income, white men – but traditionally vulnerable populations (older, less-educated, lower-income, and chronically ill) have the most to gain from PHR use.
- 71 percent of PHR users are white; 59 percent are men; 55 percent are under the age of 45; and 51 percent graduated from college.
- 55 percent of users without a college degree said they asked questions that they would not have otherwise asked, compared to 26 percent of users with a college education.
- 58 percent of users with an income below $50,000 feel more connected to their doctor as a result of using the PHR, compared to 31 percent of users with higher incomes.
- 40 percent of respondents with two or more chronic conditions that use PHRs did something to improve their health, compared to 24 percent of others interviewed.
- 22 percent of survey respondents are very familiar with doctors and health care systems using electronic health records (EHRs).
- Respondents, who say their doctor uses EHRs, are more likely to want a PHR (50% interested versus 41%). They are also more interested in devices and applications than people whose doctor does not have an EHR.
Is There a Consumer Payoff for Investing in Health Information Technology?
The California HealthCare Foundation presented findings from the ground-breaking new study on Americans' attitudes and experiences with health information technology.
This study documents -- for the first time -- specific health benefits reported by people who have been using personal health records. Other findings provide new insights to people developing health information technologies and encouraging their use -- with sometimes surprising results.
Vice President of Programs, California HealthCare Foundation
- Joshua Seidman, Ph.D.
Acting Director of the Meaningful Use Division, Office of Provider Adoption Support, National Coordinator for Health Information Technology, U.S. Department of Health and Human Services
- Steve Findlay, M.P.H.
Senior Health Policy Analyst, Consumers Union
- Kate Christensen, M.D.
Medical Director, Internet Services Group, Kaiser Permanente
- Jane Sarasohn-Kahn, M.A., M.H.S.A.
Health Economist/Principal, THINK-Health and Health Populi Blog
Full Report (now available for download at http://www.chcf.org/topics/view.cfm?itemID=134205)
National Consumer Survey on Health IT topline results
About the California HealthCare Foundation
The California HealthCare Foundation is an independent philanthropy committed to improving the way health care is delivered and financed in California. By promoting innovations in care and broader access to information, our goal is to ensure that all Californians can get the care they need, when they need it, at a price they can afford. CHCF commissions research and analysis; publishes and disseminates information; convenes meetings of key health care groups; and funds development of programs and models aimed at improving health care in California.