Wednesday, January 22, 2014

A Very Interesting Review Of Older Individual’s Views On The PCEHR. Very Interesting Indeed!

This appeared a few days ago.

Seniors reluctant to share PCEHR with all health professionals

By Natasha Egan on January 15, 2014 in Consumers, Health & medical, Technology
Most senior Australians are willing to grant their GP, specialists, hospital medical staff and emergency workers full access to their electronic health record but are not inclined to do so for other health professionals or carers, according to a study targeting over-65s in regional Australia.
Education is therefore needed about the importance of all health professionals having a full picture of a patient’s health, says a co-author of the paper, which was recently published in the International Journal of Medical Informatics.
The La Trobe University pilot study on the views of elderly regional Australians of personally controlled electronic health records (PCEHR) involved 80 seniors from Bendigo in Victoria. The bulk of the participants, which were recruited at local Probus clubs catering to active and retired professionals, were aged 60 to 79 (84 per cent) and most were female (62 per cent).
The study found that the vast majority of respondents were in favour of giving their usual GP full access to their PCEHR (95 per cent) and most were also willing to grant full access to specialists (85 per cent), hospital medical staff (79 per cent), and emergency personnel (78 per cent).
Just over half of participants thought family members (53 per cent) should have full access to their eHealth record, however, fewer than that felt it suitable for diagnostic laboratories (48 per cent), pathology staff (46 per cent), allied health professionals (45 per cent), pharmacists (44 per cent), and carers (29 per cent) to have full access to their online health information.
Much more here:
Here are the study recommendations:
“Recommendations
To increase the adoption of the PCEHR among regional dwelling older Australians, the authors have recommended measures including computer access points in GP practices, print-out facilities, reassurance about security, and increased awareness about the benefits of sharing health record content with various health professionals.”
There is further coverage here:

Elderly reluctant to share health records with pharmacists

15 January, 2014
Australians aged over-65 would prefer family members and pathology lab staff to have access to their Personally Controlled Electronic Health Record (PCEHR) than pharmacists, a study reveals.
The research, published in the International Journal of Medical Informatics, found that 95% of elderly Australians said they would be happy to give their GP full access to their PCEHR, while just 44% said pharmacists should have access to the document, the Australian Ageing Agenda reported.
The authors from La Trobe University used a self-administered questionnaire, distributed to members of a community club for active business and professional retirees, to gauge their views on the PCEHR.
More here:
There is an abstract to the actual study found here:
This is a very interesting study showing the barriers that need to be overcome to get decent levels of participation in the PCEHR - if you think that is a good thing.
That 25% or so of this group lack internet access seems to me to be a barrier that will be hard to overcome as will the education of this cohort in computer use.
Well worth a read of the articles above and the full text if you have access.
David.

3 comments:

Bernard Robertson-Dunn said...

"Education is therefore needed about the importance of all health professionals having a full picture of a patient’s health, says a co-author of the paper, which was recently published in the International Journal of Medical Informatics."

And "the authors have recommended measures including ... reassurance about security ..."

Isn't this a bit arrogant and authoritarian? People don't trust the PCEHR so the proposed solution is to tell people they are wrong.

Maybe the authors should listen to information systems professionals who do not share their trust in the system.

Maybe the authors need to be educated about the importance of the PCEHR being built to meet equally the needs and requirements of both the community and health professionals, with the community needs trumping others where there are conflicts.

And the issue of access to the PCEHR by all members of the community should have been addressed in the business case. Anybody know if it was? If it wasn't?

Tom Bowden said...

Hear hear Bernard!

My immediate thought was that this is an extraordinary conclusion to jump to. - They don't like it so lets 'educate them as to why they should'

Instead of asking; how would they like to see the problem solved?, and while we are at it, have we correctly defined the problem?

Terry Hannan said...

David, here are two recent publications that I believe are also relevant to this topic. Terry
1. The Road toward Fully Transparent Medical Records Jan Walker, R.N., M.B.A., Jonathan D. Darer, M.D., M.P.H., Joann G. Elmore, M.D., M.P.H., and Tom Delbanco, M.D. n engl j med 370;1 nejm.org january 2, 2014
2. Urmimala Sarkar, DavidW. Bates, Care Partners and Online Patient Portals JAMA January 22/29, 2014 Volume 311, Number 4