Saturday, February 12, 2011

The Markle Foundation Is Doing Some Interesting Attitude Research on E-Health.

In a press release they describe a large survey done with US patients and clinicians.

Doctors and Patients Overwhelmingly Agree on Health IT Priorities to Improve Patient Care

Support for Online Access to Information and Privacy Protections

January 31, 2011

NEW YORK—Doctors and patients overwhelmingly agree on key requirements for information technology (IT) to increase the quality, safety, and cost-efficiency of care, as well as core privacy protections, according to a national survey released today by the Markle Foundation.

The Markle Survey of Health in a Networked Life is the first of its kind to compare the core values of physicians and the general public, referred to here also as patients based on their opinions as consumers of health care, on deployment of information technology in health care. It comes at the start of a new federal program to help doctors and hospitals upgrade from paper to electronic health records.

"Doctors and patients agree on the importance of putting accurate information in their hands to improve the quality, safety, and efficiency of health care," Markle President Zoƫ Baird said.

"A surprising 74 percent of doctors say they want to be able to share patient information with other professionals electronically. As medical professionals shift from paper records to electronic systems, this survey shows that the public and physicians overwhelmingly agree that we need to measure the payoff from investments in information technology in terms of better health and more cost-efficient care," Baird said.

Agreement between doctors and the public was strongest on requirements to ensure that new federal health IT incentives will be well spent. The funding was included in the stimulus bill passed by Congress in 2009.

"Roughly 80 percent majorities of both the public and doctors agreed that it’s important to require participating hospitals and doctors to share information to better coordinate care, cut unnecessary costs, and reduce medical errors," said Carol Diamond, MD, MPH, Managing Director at the New York-based nonprofit foundation.

"By the same overwhelming margin, four in five doctors and patients expressed the importance of privacy protections for online medical records, an expectation we have repeatedly found on the part of the public in our previous surveys," Diamond said. "They also agree on the importance of measuring progress. This survey is a powerful indication that the public and physicians alike want investments in health IT to come with accountability."

Survey Shows Many Doctors and Patients Believe Key Information is Lost in Their Health Care Conversations

Of the doctors surveyed, 94 percent said their patients at least sometimes forget or lose track of potentially important things they are told during doctor visits, and 34 percent of the doctors said they themselves at least sometimes forget or lose track of potentially important things that their patients tell them. Among the patient group, 30 percent perceived that their doctors forget or lose track of potentially important information at least sometimes.

According to the Markle Survey of Health in a Networked Life, we have found that:

· Among the doctors, 74 percent would prefer computer-based means of sharing patient information with each other. (Only 17 percent of doctors predominantly use such means today.)

· Nearly half (47 percent) of the doctors would prefer computer-based means of sharing records with their patients. (Only 5 percent do so today.)

· Yet 74 percent of doctors said patients should be able to share their information electronically with their doctors and other practitioners.

· Among the public, 10 percent reported currently having an electronic personal health record (PHR)—up from 3 percent who reported having one in Markle’s 2008 survey.

· Roughly 2 in 3 of both groups (70 percent of the public and 65 percent of the doctors) agreed that patients should be able to download their personal health information online.

· And 70 percent of the public said patients should get a written or online summary after each doctor visit, but only 36 percent of the doctors agreed. (Only 4 percent of doctors say that they currently provide all their patients a summary after every visit).

"Our past surveys show that most US adults believe personal health records that include copies of their own medical information would help them improve their health and communicate better with health professionals," said Josh Lemieux, Director of Personal Health Technology at Markle. "With this survey, we find an increase in PHR use and learn that roughly two in three doctors agree that patients should have the option of online access to their personal health information. The survey also confirms that having modern information tools comes with expectations for privacy protections."

Other findings from the Markle survey include:

· Majorities of 70 percent to 80 percent of both patients and doctors support privacy-protective practices, such as letting people see who has accessed their records, notifying people affected by information breaches, and giving people mechanisms to exercise choice and correct information.

· Majorities (65 percent of the public and 75 percent of doctors) agreed that it’s important to have a policy against the government collecting personally identifiable health information for health IT or health care quality-improvement programs.

· If there are safeguards to protect identity, however, at least 68 percent of the public and 75 percent of the doctors expressed willingness to allow composite information to be used to detect outbreaks, bioterror attacks, and fraud, and to conduct research and quality and service improvement programs.

· Large majorities of the public (75 percent) and the doctors (73 percent) said it will be important to measure progress on improving health care quality and safety to ensure the public health IT investments will be well spent. Both groups (each at 69 percent) agreed on the importance of specific requirements to improve the nation's health in areas like heart disease, obesity, diabetes, and asthma.

· Many are unaware of the health IT incentives: 85 percent of the public and 36 percent of doctors describe themselves as not very or not at all familiar with the health IT incentives program, which makes subsidies available for doctors and hospitals to increase use of information technology.

"We all have a stake in making sure that information is protected and trusted so that it can be put to best use to improve our health," Diamond said. "This survey shows that doctors and their patients share many of the same hopes and expectations for advancing health in a connected world."

Knowledge Networks (KN) conducted the surveys between August 10 and 26, 2010. The general population survey of 1,582 adults age 18 and older used KN’s KnowledgePanel®, a probability-based panel of 50,000 individuals designed to be representative of the US population. The survey of 779 physicians was conducted using KN’s Physicians Consulting Network (PCN), an invitation-only list of more than 45,000 practicing physicians.

Results are available at www.markle.org.

The release is found here and all the links found there point to aspects of the results. This is really pretty useful material on a range of topics

http://www.markle.org/news-events/media-releases/doctors-and-patients-overwhelmingly-agree-health-it-priorities-improve-pa

Interestingly Markle is also involved in an earlier study that has just been published.

Docs differ widely in PHR attitudes: study

By Maureen McKinney

Posted: February 3, 2011 - 11:45 am ET

Despite the potential benefits of personal health records for patients, physicians differ widely in their past experience with PHRs and in their willingness to use them in their practices, according to a study published in the journal Health Affairs.

The study's authors—the director of the Institute for Ethics at the American Medical Association, a doctoral student in public policy at the University of Chicago and the director of personal health technology at the New York-based Markle Foundation—surveyed 700 physicians in 2008 and 2009 about their use of PHRs. A majority, 64%, had never used one in their practices. About 42% of respondents said they would be willing to use PHRs; 24% expressed unwillingness to use the tool.

But belief in the usefulness of personal health records also varied significantly. "Even among those willing to use them," the study's authors wrote, "fewer than half of physicians believed that these tools would save time, improve their relations with patients or improve accuracy."

More here:

http://www.modernhealthcare.com/article/20110203/NEWS/302039989

The apparent differences in attitudes is very interesting and begs the question of just how current such research has to be to remain relevant for decision making. It looks here that there has been an evolution of views over quite a short period.

Again we have evidence in some areas for high levels of currency!

David.

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