EHR use by doctors will foster personal health record uptake

Tech companies looking to sell consumer IT products need to build off current technologies instead of creating devices

A lack of electronic medical data from doctors, complicated setup processes and the static nature of personal health records (PHRs) have caused U.S. consumers to shun the products. But PHR use should increase as more doctors use electronic health records (EHRs) and tech vendors develop offerings that are easier to use.

PHR use "is not incredibly high, but it is growing," said Lygeia Ricciardi, senior policy advisor for consumer e-health at the U.S. Department of Health and Humans Services. She cited a 2011 study from consulting firm Deloitte that found usage stands at 11 percent, a 3 percent increase from the 2008 survey.

Consumers interested in PHRs face compartmentalized offerings with enterprise IT vendors looking to unite the silos, said Liz Boehm, principal analyst, customer experience for health care and life sciences, at Forrester Research.

Entities that pay a person's health care claims, such as a health insurance provider, offer PHRs containing claim information, but lack clinical data like lab results, said Boehm. Doctors, using health care software from companies including GE and Epic Systems, can offer PHRs that include clinical data. These records prove "less useful," though, since they cannot link to a patient's pharmacy or another health care provider's system.

Microsoft's HealthVault PHR service, launched in 2007, attempts to bridge the gap between health care payer and provider systems, she said. HealthVault's objective is for doctors, pharmacies and other care providers to "feed their data into this record that is centered around the consumer."

Google also offered a PHR product, Google Health, but in June the company announced that it would end the service on Jan. 1, 2012. In a blog post, the company attributed its decision to Google Health's "limited usage."

Federal government mandates that require doctors to migrate to EHRs from paper-based systems will help solve the data issue, Ricciardi said. With "more providers coming online and with more access to digital information for consumers," she expects to see a "spillover effect" that will boost PHR adoption.

Linking EHRs to PHRs will "absolutely" increase PHR use, said Boehm. A doctor's involvement "fundamentally changes what the PHR is and what's being offered."

And this data influx should spur tech companies to offer PHR products.

"Until you have all that data flowing, sometimes it's hard to encourage industry to go ahead and develop all these applications because it's potentially too early," Ricciardi said.

Offering consumers their medical histories electronically should ease setting up a PHR, a process that now may involve manually entering the data. Current products "can be challenging for consumers to use," Ricciardi said.

People "can't easily get their information in an electronic form to flow into" a PHR, she said. "If they're trying to use a stand-alone product and type it in all by hand, that's tough. When it becomes ... easy to download their information, I foresee interest in that area growing."

Tech companies need to consider developing components that extend PHRs beyond just an "electronic filing cabinet." Using a PHR to solely store medical information has merit, Ricciardi noted. People can review their records for errors and work with health care providers to make them complete.

However, a static PHR isn't "as compelling as file cabinet plus cool, interactive stuff," she said. People need a reason to access their PHR besides to add data.

"They want things they can do with their information," she said. "They want interactive applications, games, things that engage them in their health. There are more reasons to actually access and use your health information if more of these tools were out and about."

People need to see value in using a PHR and that proposition remains "pretty unclear," said Boehm.

"Labs results and prescription refills are the number-one and number-two reasons people go to their Kaiser PHR," she said, referencing the PHR offered by health care consortium Kaiser Permanente.

While consumer enthusiasm about using PHRs is tepid, the overall consumer use of health IT is strong, according to data Ricciardi studied. She cited a study from the Pew Research Center's Internet & American Life Project that found 80 percent of people online search for health information. The Web also offers people online communities where they can get advice on a variety of medical topics.

Consumers also want mobile devices to help keep them healthy.

"We have seen data that people show interest in using medical devices or smartphones to monitor health," she added.

Tech vendors looking to enter the space need to consider user interaction when developing products. People need technology that helps them improve their health without undertaking a complicated process, said Ricciardi.

"You have to meet consumers where they are," she said. "Instead of creating new devices, use something that people are already using, whether it's their cellphone or smartphone."

Even as people use tech to stay well, doctors still have a role in educating patients about using IT tools to manage their health.

"Clearly the provider plays an important role in encouraging people to learn and do things," said Ricciardi.

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