How to welcome patients to the HIT party

There's plenty of incentives for consumers to embrace health information technology and to get more engaged in their own health data.

For example, the Office of the National Coordinator and the Blue Cross Blue Shield Association both recently announced initiatives to engage patients in healthier living and more involved decision-making by encouraging their use of HIT. This year's Consumer Electronics Show in Las Vegas was chock-full of new HIT apps and devices targeted to consumer-shoppers. Even the payer industry has married their members with HIT.

Still, a study published this month in the Journal of the American Medical Informatics Association showed patients are often indifferent about their own care--at least in terms of personal health record use. In the study, patients were provided with free access to PHRs, which were "tethered" to their physicians' EHRs. The researchers theorized that the availability of PHRs would increase the patients' involvement in the monitoring and care of their hypertension.

However, the study ran into a problem: most of the patients didn't bother to use the PHRs. So they didn't access their EHRs, track their condition or interface with their physicians electronically. As a result, the PHR had no impact on patient outcomes. Simply making the PHR available did not make them happier or healthier.

What happened? PHRs were widely touted as the way to engage consumers in HIT and induce them to take an active role in their care. But the patients apparently weren't very interested in doing so.

It has been suggested that patient apathy is the primary reason for PHR failures.

That's probably a component of the problem, but it's more complicated than that. After all, patients seem to be less apathetic about HIT when they see a direct impact or have a direct stake, say in their wallet.

For instance, consumers are becoming more likely to check payer and social media websites for cheaper medical imaging and other services now that they pay a greater share for procedures due to higher copays and participation in high deductible health plans. They'll soon be able to view on the website whether or not their physician received money from a pharmaceutical or medical device manufacturer for that drug or implant he or she just prescribed for them.

So why are PHRs a roadblock? Maybe because using one takes work. After all, patients need to input and transport data into the PHR, keep it up to date and interact with the data. Why bother, if a patient knows that he can simply ask his doctor for the information? 

Look how hard it's been for physicians and hospitals to adopt EHRs. EHR implementation is only taking off now that the government is paying providers incentive money to adopt them.

The researchers of the hypertension study did offer several suggestions to entice patients to use PHRs:

Make patients more tech-savvy. The researchers found that the patients who self-identified as computer- knowledgeable and owners of internet-connected tools were most likely to use the offered PHR. The researchers surmised that as more consumers adopt mobile technology, more of them will view themselves as capable of successfully using the PHR.

Educate them regarding the benefits of the PHR. Patients may be more likely to take advantage of the PHR if they believed there was a clinical need to use them.

Address patients' privacy and security concerns. The study noted that the fear of the loss of confidentiality was a major deterrent.

Culture change takes time, and it's never easy. But let's not throw in the towel on this one just yet. It's only January. -Marla

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