Veteran use of PHRs remains low

Most veterans are not taking advantage of the personal health record (PHR) and patient portal available to them, according to a new study published in the Journal of Medical Internet Research (JMIR).

The researchers--who represent several Veterans Affairs hospitals, as well as Boston University, the University of Massachusetts, Indiana University and Yale--conducted a cross section analysis of veterans with at least one inpatient admission or two outpatient visits between April 2010 and March 2012. Among those 6 million veterans, less than one-fifth (18.64 percent) had registered for MyHealtheVet, the VA's patient portal. Only 10.03 percent had authenticated their identity so that they could use it; 4.05 percent had opted for secure messaging and 11 percent had used it for a prescription refill.

The rates of usage varied from 9.30 percent to 34.9 percent from facility to facility. They also varied by medical condition. Veterans with post-traumatic stress disorder, spinal cord injuries, depression, anxiety and HIV used it the most; patients with certain complex medical conditions, such as hepatitis and congestive heart failure, had the lowest use.

"[O]pportunities are being missed for supporting those with medical conditions that require intensive treatment and self-management via functions of a tethered PHR," the study's authors said. "These groups should be provided with outreach and supported with interventions including training or educational materials and proactive 'help desk' support."

The researchers did acknowledge that PHR reach had increased from 16.3 percent in July 2009. They also suggested that further research be conducted to examine how the need to manage multiple comorbid medical and mental health conditions impacts PHR adoption and use.

Other studies have reported on the apparent disconnect between patient acceptance of portals and their actual use of them. A prior study of MyHealtheVet also found low usage rates, but patient satisfaction of the portal was high among the veterans that used it. That usage may increase as veterans became more adept at using technology.

Another study found that physician practices can increase patient use of portals if they customize their promotion and integrate it into the patients' routine care.

To learn more:
- here's the study