Patients say they want transparency and instant access to their healthcare information, yet most remain on the sidelines when it comes to using these tools. Maybe that's no surprise when many physicians are still getting up to speed on EHRs. That may change — and soon. Stage 2 of the federal EHR meaningful use incentive programs requires that eligible providers make more healthcare information available electronically to more patients starting in 2014 — personal health records (PHRs) can help physicians reach that goal.
Still, meaningful use is not the primary motivator for PHR adoption, say medical practices using the technology successfully. Instead, it is driven by patient expectations, adept integration of information systems, and demands for value from physicians, patients, and payers.
So far, the PHR installations that seem to gain the quickest acceptance from patients share three elements: user-friendly technology, tie-in to a medical practice's website, and the encouragement of physician advocates.
Here's more information on what's driving the adoption of PHRs, what value they bring to practices and patients, and key tips for implementing them and encouraging patients to use them.
Patient expectations
Although recent surveys indicate disinterest in PHRs among patients — about 10 percent of Americans used them in 2011, according to Deloitte Center for Health Solutions — Brock Morris, chief information officer at Redmond, Wash.-based Pediatric Associates, hears a different story from parents of the practice's patients. That's probably no surprise, he says. Many of the parents bringing their children to the 85-physician multisite practice also work for the city's top private employer, Microsoft Corporation. "The parents of our patients tend to be a technically-minded demographic," Morris says. "We get asked all the time: 'What new services and solutions can you provide us?'"
PHRs, he adds, are a natural extension of his patients' parents' everyday experiences. "The parents are used to having information at their fingertips and being able to control it. They are frustrated when they want their child's immunizations or a growth chart and are told they have to wait a few days. In almost every other environment today, people get information quickly and can manage it themselves."
As younger, more tech-savvy patients become more active users of medical practices, the drive toward PHR adoption will increase. Indeed, Morris notes that younger generations of patients, including the parents he hears from at Pediatric Associates, gravitate to websites, text messaging, and other forms of communication.
Improved capabilities
Pediatric Associates is one of several practices around the nation involved in pilot testing interfaces between Microsoft's Web-based HealthVault PHR and their EHRs — Greenway's EHR in the case of Pediatric Associates. The approach aims to tie PHRs to EHRs via websites and, potentially, tie both to the medical devices patients use at home.
Morris says the beta version his practice is trying out allows parents to pull continuity-of-care documents (CCDs) about their child's care from the EHR and into HealthVault. Parents also can hook up their child's glucose monitor — and soon, other home health devices — to electronically enter data into the PHR to share with the child's medical team.
The pilot projects hope to overcome a barrier hobbling the prospects of free-standing, or "untethered," PHRs — lack of tight integration with a patient's clinical records and his provider's website.
Any individual can use HealthVault on the Web or via apps to create untethered accounts. But because HealthVault also supports common exchange formats, like CCDs, it essentially becomes a tethered system capable of electronically connecting with home health devices and a configured EHR.
