Patients lack access to, knowledge of digital health communication tools

Many Americans lack access to and knowledge of digital tools such as text and email reminders that can boost communication efforts with their healthcare providers, a new survey by the Council of Accountable Physician Practices (CAPP) and the Bipartisan Policy Center finds. What's more, few primary care doctors even recommend such technology options, consumers who responded to the survey say.

For the survey, unveiled Nov. 4, Nielsen Strategic Health Perspectives last summer polled 5,014 U.S. residents over the age of 18; in addition, 626 doctors also were surveyed.

Just 29 percent of consumer respondents said they receive electronic reminders for appointments, refills or suggested care; 14 percent said they have the ability to conduct online checks of their medications. Fifteen percent of respondents said they use email to communicate with their provider.

Regarding text reminders for appointments and medications, only 9 percent of respondents indicated they receive the former, while 4 percent said they receive the latter. Of 1,426 respondents whose income level was below $35,000 annually, those figures stood at 6 percent and 2 percent, respectively. For 559 respondents on Medicaid, those numbers were 5 percent and 2 percent, respectively.

Despite the low access numbers, the survey showed that interest in access to such tools and services is present. For instance, while 28 percent of respondents said they have access to a portal to log on and see their information, 34 percent of respondents said they want such access. What's more, while 15 percent of respondents said they correspond with their provider via email about their health, 25 percent of respondents said they want the ability to do so.

Physicians, however, aren't necessarily responding. Only 11 percent of patient respondents said their primary care doctor has recommended the use of email reminders. Additionally, 8 percent of patients said their doctor recommended using text reminders, while 5 percent said such recommendations were made for the use of mobile apps to track physical activity levels.

Permanente Medical Group Executive Director and CEO Robert Pearl (pictured), who also serves as chair of CAPP, said in a press conference announcing the survey's results that the problems of the 21st century cannot be solved with the tools of the past, but added that we're far away from a reality of patients having the same functionality in healthcare as they do in their daily lives. Four reasons for that, he said, are:

  1. A lack of integration of such tools in the care structure
  2. The current fee-for-service system
  3. The need for better physician leadership
  4. Legislation that's not up to date with the current state of technology

"Many of the rules written around electronic health records and mobile devices were written before the smartphone existed," Pearl said.

He added that changes to the present-day payment model to one that rewards quality results will be crucial to helping doctors increasingly embrace technology.

"As we move from fee-for-service to a variety of ways of prepayment, there's no question that it should facilitate this technology," Pearl said. "If you're going to be rated and then evaluated and rewarded based upon quality and patient satisfaction … technology is a great way to provide that care. ... If you have a situation where you're going to be rewarded for avoiding a heart attack rather than just treating it, which is what technology allows to happen, you're going to be in the same situation where you're going to want to make these investments and make the processes occur."

To learn more:
- check out the survey results (.pdf)
- read the accompanying announcement

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