The California HealthCare Foundation released its findings on a survey about consumers and health IT, specifically PHRs. Historically PHRs have not gotten great adoption by consumers or general acceptance by industry stakeholders because the patient health data wasn't portable or incorporated into EHRs. That’s changing as technology continues to evolve. The survey mirrors those changes.
What's happening in the PHR world directly impacts what's happening in the EHR world. Most care is self-care, which takes place outside of the healthcare delivery system, said Joshua Seidman, acting director of the Meaningful Use Division, Office of Provider Adoption Support, Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services. HHS has made patient-facing technology an important component of its health IT program. Research like the California HealthCare Foundation survey needs to be ongoing to better understand why and how patients are using these consumer technologies, he said.
Seidman said the critical finding of this particular survey is the frustrations consumer experience with management of their healthcare - wanting to know more about loved ones' care, wanting their physicians to talk with them more, feeling like they have to be their own advocate, wishing that their multiple physicians would share and talk more about their patient information, and so on. "These frustrations are really important for us to consider if meaningful use is going to be successful," he said.
Seidman is spot on. It's all well and good if healthcare systems and physicians offices have EMRs and EHRs that demonstrate meaningful use. If patients aren't engaged in taking care of themselves and following treatment plans because of any one or more of these frustrating issues, clinical outcomes won't improve.
Technology can address some of these issues, many of which sit squarely on the providers' lap. After the learning curve and the cultural and workflow transformations are behind them, if EMRs and EHRs can make physicians more efficient and share patient information they should be able to spend more quality time with their patients. This would eliminate another point of frustration.
ONC and HHS are right in having one component of the health IT program study and advance patient-facing technologies. Just as there is work to be done in making EHRs and EMRs more user friendly, PHR design must incorporate ease of use.
At the press briefing on CHCF's survey results, Kate Christensen, MD, medical director for Kaiser Permanente's Internet Services Group, said the survey results validated what they have been seeing with their own PHR usage. Going forward, and not resting on its laurels, she said, "What we need to do to lead the way is make sure we're developing a tool people can really use. We need to listen to them."
Steve Findlay, senior health policy analyst for the Consumers Union, agreed. He highlighted the surprise survey finding that less-educated, lower-income, chronically ill patients reported greater value, even though they are using PHRs less than the highly educated, higher-income, healthier traditional PHR users. "The big task in the future is to make PHRs - HIT tools - easier to use for those who are less educated and have lower health literacy, which is half or more of the population," he said.
