Yesterday, the California Health Care Foundation (CHCF) released a consumer survey report looking at perspectives on healthcare IT, privacy of personal health information (PHI) and use of internet tools, such as PHRs to manage their health or health of a loved one.
Having reviewed the slide deck and survey/data report, following are some initial impressions:
Inclusive survey sampling a broad cross-section of the US, including age, racial and socio-economic classes.
Surprising PHR adoption at 7% of respondents (our own research in this market pegged adoption at ~3.5%). Highest adoption out west, likely the result of Kaiser’s big push on the PHR front with their MyChart. Nearly 90% of PHR users use it for personal health (i.e., not in a caretaker role).
One of the more bizarre findings was that 58% of respondents were likely to use a PHR from a provider (OK, that is logical) but 50% said they would use one from a payer! Using a PHR from a payer? That flies in the face of numerous studies that have found that consumers trust payers with their PHI about as much as they trust their employers – very little. Something strange going on here.
The survey reports that Google and Microsoft are about as likely to be used in this capacity as an employer sponsored PHR. Such a finding does not bode well for the employer-led platform, Dossia, Google Health or Microsoft’s HealthVault.
Another bizarre result was that of the various demographics that currently use a PHR, nowhere on this list was the female head of household. This is quite contrary to the experiences of others, including WebMD and other PHR providers who’s number one user is the family CMO, the mother.
Arguably the best findings from this survey are:
- PHR usage leads to a more informed and engage consumer.
- Lower income, less educated PHR users and those with chronic diseases derive the greatest benefits through PHR usage.
- Privacy concerns drop by nearly 50% once someone begins actually using a PHR.
While there are some aspects to this survey that give one heartburn, or at least cause puzzlement, overall this is a good cut at providing a snap-shot of where we are today in the use of such tools by consumers. We still have a long way to go to drive further adoption, but PHR adoption/usage does appear to provide broader societal benefits. Now the question is:
How will policy makers use these results to guide future decision making as we move further along the path of ARRA, HITECH and clinician adoption and use of HIT? To date, there has been very little out of Washington that addresses the consumer. Hopefully, this will act as a wake-up call for without consumer/citizen support much of the intent of the HITECH Act will be wasted.
John Moore blogs regularly at Chilmark Research.
