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Study points to challenge of patient engagement
As everyone knows, Stage 2 of ONC’s Meaningful Use requirements ramp up the level of patient engagement providers must demonstrate in order to qualify for incentive payments. But a recent study gives a glimpse at just how difficult that may be.
In the report published in the Annals of Family Medicine, researchers looked at the potential for increasing the role of Personal Health Records (PHRs) in the effort to get patients more plugged into their healthcare. For starters, however, they note that “there is . . . a shortage of objective evidence that personal health records can achieve these . . . improve outcomes, or even be used. Fewer than 3% of Americans have an electronic personal health record, and most of these records lack the” functionality needed to be truly useful in helping patients monitor their health.
To develop a better idea of the potential of PHRs, the researchers gave 4,500 patients randomly selected from eight Northern Virginia primary care practices access to an enhanced Interactive Preventive Health Record (IPHR). “Outcomes were measured using patient surveys and electronic medical record data and included IPHR use and service delivery. Comparisons were made between invited and usual-care patients and between users and nonusers among those invited to use the IPHR.”
The results: “At 4 and 16 months, 229 (10.2%) and 378 (16.8%) of invited patients used the IPHR.” In other words, over a period of a year the number of patients increased rather significantly. While such an increase is encouraging, the researchers note, first, “the small absolute number of IPHR users, which provided inadequate power to show changes in effectiveness outcomes for the entire intervention population.” They then discuss the amount of effort required to move patients to PHRs.
For example, “Recent evidence, in which aggressive promotion of personal health records by two large health systems resulted in annual adoption by only 10% to 20% of patients, suggests that our adoption rate (16.8%) is favorable for promotion based on a simple mailed invitation. Motivating even more patients to use a personal health record with advanced functionality may require practices to make major changes. To understand the value and relevance to care, patients may need information about the tool, how it works, and why it is important for them. This information is perhaps best explained during the course of multiple patient contacts and reinforced by all health care team members.”
In short, it is possible to get patients to pay more consistent attention to their health information, but it takes time and considerable effort. Like it or not, that’s a fact policymakers should remember as they determine the level of patient engagement for which providers are ultimately responsible.
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