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4/8/2011
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Consumers Slow To Adopt Electronic Personal Health Records

Some patients are still concerned about online security, while healthy consumers seem indifferent to the benefits of PHRs, according to a study by IDC Health Insights.

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Consumers have been slow to adopt personal health records (PHR), a Web-based tool designed to encourage consumers to engage in their healthcare by tracking and aggregating their health information online, according to a study from IDC Health Insights. The findings come at a time when other technologies such as electronic health records, mobile health devices, e-prescriptions, and other technologies are seeing accelerated rates of adoption as healthcare delivery organizations implement systems to manage patient data.

The report – "Vendor Assessment: When Will PHR Platforms Gain Consumer Acceptance?" -- was based on an online survey of 1,200 consumers between February 18 and February 23, to gauge their interest in PHRs and to compare the numbers with a similar report conducted in 2006.

Published last month, the survey found that widespread consumer adoption of PHRs remains elusive despite numerous PHR options offered by providers, health plans, and employers as well as third-party vendors like Dossia, Microsoft HealthVault, and Google Health.

According to the IDC Health Insights' survey, only 7% of respondents in 2011 reported ever having used a PHR, and less than half of these respondents (47.6%) are still using one to manage their family's health. Further, the majority of respondents (50.6%) said that the reason why they had not used the online technology was that they were not familiar with the concept of a PHR. These results were similar to a 2006 IDC Health Insights study that showed approximately 7% of respondents indicated that they used a PC-based or Web-based PHR, and a little more than half (51.9%) were unaware of PHRs.

"PHR adoption by consumers is never going to be ubiquitous. There will always be consumers that will not want to store their personal health information online," Lynne Dunbrack, the report's author and program director for Connected Health IT Strategies at IDC Health Insights, said in an interview.

Dunbrack said that those healthy consumers who don't have a reason to engage the healthcare system won't see the value in using a PHR. However, a slight increase in adoption rates is more likely to occur among patients with serious illnesses such as cancer, diabetes, or other chronic conditions that require ongoing care over long periods of time.

Providers and health plans actively promoting the benefits of PHRs should also increase the number of people who adopt them. Dunbrack predicted that during the next 18 to 36 months there will be a modest increase in PHR use to monitor lab results, blood pressure, glucose readings, and other vital data associated with seriously ill patients.

In fact, while the report showed lackluster PHR adoption rates, it also showed that three out of four consumers would start to use a PHR under certain circumstance. For example, a clinician recommendation (37.4%) was a primary motivator. And slightly more than 20% said they would use a PHR if they or a family member experienced a healthcare event that showed the importance of having the information available (11.9%) or was diagnosed with a chronic disease or complicated health issue (9.4%).

"More education is required. The decision to use a PHR is event-driven at the point of need (e.g., requesting a prescription renewal, receiving a diagnosis of a chronic condition or expressing a fitness/health goal of losing weight). The consumer should be made aware that a PHR is available and how it might help them support their various health needs," Dunbrack said. "Again, the recommendation might come from their physician (or someone in his or her office) or the health plan, particularly by a care manager in the case of a member being enrolled in a disease management program."

Other key finding from the study are:

-- Consumers rated their comfort level with Google Health and Microsoft HealthVault similarly; approximately one in four respondents reported he/she was comfortable using Google Health or Microsoft HealthVault.

-- The primary sources for PHRs are hospital or physician websites (25%) and health plan websites (21.4%).

The report also outlined major barriers to PHR adoption, which the report said have persisted over the years. These are:

-- Early PHR products required consumers to enter their own records manually or scan paper records to be stored electronically in the PHR. Approximately 16% of respondents indicated that they did not want to spend the time to input and update the information in their PHR.

-- The privacy and security of online data continue to concern consumers. In the 2011 survey, another 9.1% of respondents reported stopping their PHR use because they did not trust the security of the currently available Internet-based sites.

-- Historically, when consumers switched health plans or employers, information stored in their sponsored or tethered PHR could not be readily transferred, which discouraged consumers from establishing a new PHR.

Looking at the prospects for market growth of PHRs the report said: "Patient-centered medical home and accountable care models, with their focus on improved care coordination and chronic condition management, should encourage clinicians to recommend PHRs to their patients to better manage their health and wellness. But PHRs will need to continue to evolve from repositories of static health information to a tool that provides actionable information at the point of consumer healthcare decision making to be considered useful by consumers."

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