My Health Manager users gain 24/7 secure online access to their lab test results, eligibility and benefits information, and secure e-mail messaging. The organization's Epic-built EHR, Kaiser Permanente HealthConnect, ties into the PHR.
"By making these tools and resources available to our members, we are able to see a level of engagement that we were not able to see in the pen and pencil world," Larson says.
While a well-designed PHR helps patients stay in touch with their physicians, Kaiser's internal feedback indicates that convenience is the biggest attraction for patients, she says.
In early 2012, the multistate health system upped the ante by optimizing its website for convenient viewing from smartphones, tablets, and other mobile devices. The result? In just the first five months of 2012, some 6.4 million visits to the Kaiser website. Sixteen percent of its total traffic in that period came from mobile users.
"People definitely want to do things on the Web, but the convenience of having your handheld device wherever you are in the world just adds to the benefit the PHR brings to patients," Larson says. "If usability is not working, it drives people away."
Samples, of Greenway, says there are three crucial steps when it comes to engaging patients on PHRs:
1. Promotion. "Physicians and staff have to talk about the PHR to patients," he says.
2. Integration. "The PHR should allow patients to complete forms online, request appointments, ask for medication refills — functions that provide convenience," he says.
3. Provider utilization. "Secure communication with the physician is important because the patients will eventually leave (the PHR) if there is no conversation going on with the physician," he says.
Prior to promoting its PHR, like Kaiser, the Cleveland Clinic also spent time determining what aspects of a PHR would appeal most to patients, says internist Martin Harris, chief information officer, Cleveland Clinic. First, the clinic engaged physicians in the PHR's design. Then, it formed patient focus groups to determine what features to offer.
But it didn't stop there. It promoted the system through its website, printed materials, and signs in medical offices. Patients also received verbal encouragement to sign up during visits; and others were drawn in by kiosks conveniently placed in offices.
Harris says that promotion and focus on ease of use paid off. Its PHR, MyChart, blossomed from a small pilot study with 3,000 patients in 2005, to a system with 450,000 users in June 2012. Each month, between 5,000 and 7,000 new users sign up, he says.
A chief concern of physicians early on at the Cleveland Clinic was whether the PHR would give patients the ability to see test results or other diagnostic findings before their physicians had a chance to review them, says Harris. The initial usage guideline called for a five-day delay when releasing test results. That was reduced to three days after patients complained about the time lag. Now, except for new diagnoses of cancer or other sensitive matters, the system automatically populates the PHR after two days, regardless of whether the physician has seen test results. Physicians can also choose to release information sooner or put it on hold.
"It's important for all patients to be informed, but this information has real value, too, for the acutely ill," Harris says. "The office encounters can be very complex, with several events in a short period of time. With the PHR, the physician has a way to get more information and send reminders to the ill patients without requiring them to come in every time."