Wednesday, May 04, 2011

Another Truth We Need To Have NEHTA / DoHA Grasp. Access To Clinical Information Has to be Useful.

The following useful report appeared a little while ago

More than half of Kaiser members use PHR

8 April 2011 Linda Davidson

US healthcare provider Kaiser Permanente has achieved a 58% adoption rate for its electronic personal health record among eligible members.

HC2011 in Birmingham was told that the PHR, My Health Manager, enables 3.4m members to email their doctor, manage repeat prescriptions, book appointments and conduct other health transactions online.

Anna-Lisa Silvestre, vice-president, online services, described how Kaiser Permanente worked to promote the service but added: “What really drives adoption is that there is relevant information and transactions that people want to use.”

She said that the number of older members using My Health Manager proved higher than expected, with a 40% adoption rate.

However, the ethnicity of users was a concern, with lower adoption rates among Hispanic members than white members. Kaiser Permanente is addressing this by producing more pages on the My Health Manager site in Spanish.

Even teenagers, who have fewer health issues than older groups, have clocked up a 20% adoption rate, she said.

“Slightly more women than men are registered,” reported Silvestre. “We believe that’s because they often caregivers.”

The most-used features are: test results; “create a message” for communicating by email; “my prescriptions” for managing medications and the “appointment centre”.

Overall, the adoption of the secure messaging service in primary care has reduced the proportion of physician’s office (surgery) visits made by members.

Silvestre produced charts showing that between Q3 of 2007 and Q4 of 2010 secure messaging rose from 12% to 28% of contacts between members and the physician’s office, while visits to the physician’s office dropped from 72% to 58% of contacts. Telephone contacts remained steady at 16-17%.

Satisfaction rates among patients were reported to be high, with many patients saying that they had saved time by not having to visit their doctor and had experienced less disruption at work caused by having to attend appointments.

More with links to videos and so on here:

There was also a quite useful comment.



We are already doing this

12 April 2011 23:53

What is making KP's health record so popular is what we call EMIS Access here - online appointment booking, online script ordering, viewing of the record, and email access to your doctor. Other clinical suppliers are already offering parts of this, and with the move to interoperability, access to all parts of the record, GP, Acute, Community, could be pulled through into one portal, available to clinicians with patient consent too.

Let’s forget the costs and risks of a national database, and start to encouraging the GPs to open up all these services. It is the reluctance of practices to do this that is largely holding this back - that and the DoHA insistence on pushing for a central record instead of mandating that practices provide these services and access.

----- End Comment.

The following sentence really nails it.

“What really drives adoption is that there is relevant information and transactions that people want to use.”

What we have with the planned PCEHR is:

1. Little useful information for at least the first couple of years.

2. No support for the transactions the patient use most (secure e-mail to doctors, making appointments and so on).

The only why this can be delivered is a total re-design of the architecture of the PCEHR. This is what is needed to see any possibility of significant adoption.

The EMIS Access system (as mentioned in the comment) may offer some useful pointers.

While we are doing that re-design it might be a good idea to get rid of the ‘politically correct’ aspects of the presently proposed PCEHR.


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