Sunday, January 06, 2019
Another Reason (Or Two) Why The #myHealthRecord Is A Solution Looking For A Problem.
This appeared a day or so ago:
January 4, 2019 / 4:38 AM / a day ago
(Reuters Health) - Most people in the U.S. with health insurance don’t use the patient portals that are increasingly provided by doctors for online communication, a new study suggests.
In a nationally representative survey, researchers found that nearly two-thirds of insured participants had not used an online medical portal in the past year.
Disparities among those who said they’d been offered portal use, and among those who chose to use it, suggest this technology can become a source of unequal access to healthcare, the study team writes in Health Affairs.
“Previous research has shown there are real benefits to portal use. Patients become more engaged in their own health and really stick to their treatments,” said senior author Denise Anthony of the University of Michigan in Ann Arbor.
“However, new treatments in health care, and new technologies in general, can end up increasing inequality,” she told Reuters Health by email.
Anthony and her colleagues analyzed data on 2,325 insured patients who participated in the 2017 Health Information National Trends Survey and who had a medical visit during the year before the survey. The researchers wanted to understand the characteristics of portal users and nonusers and the reasons, such as technology issues or security concerns, why many patients don’t use online sites to access their medical records.
Overall, 63 percent of survey participants reported not using a patient portal during the past year, and 60 percent reported not having been offered access to a portal.
Nonusers were more likely to be men, aged 65 or older, to be unemployed, live in a rural location, have public insurance through Medicaid, have a high school diploma or less education and to lack a regular doctor. Similar characteristics, as well as being non-white, were seen among people who said they weren’t offered access to a patient portal.
People who were offered access to a portal and didn’t use it were more likely to have less than a college education, to be insured by Medicaid, to be 65 or older, live in a rural area and to be Hispanic.
Among the reasons participants gave for not using online portals, 25 percent mentioned issues with internet access, 32 percent said they had no online medical record, 70 percent said they preferred to speak directly to the doctor, and 22 percent were concerned about privacy issues.
Here is the article link:
Here is the abstract from the paper cited:
PUBLISHED: December 2018
Patient portals that provide secure online access to medical record information and provider communication can improve health care. Yet new technologies can exacerbate existing disparities. We analyzed information about 2,325 insured respondents to the nationally representative 2017 Health Information National Trends Survey to examine characteristics of portal nonusers and reasons for nonuse. Sixty-three percent reported not using a portal during the prior year. In multivariable analysis, we found that nonusers were more likely to be male, be on Medicaid, lack a regular provider, and have less than a college education, compared to users. Similar disparities existed in who reported being offered access to a portal, with nonwhites also less likely to report being offered access. Reasons for nonuse included the desire to speak directly to providers and privacy concerns, both of which require recognition of the important role of provider communication and patient-provider relationships.
Here is the abstract link:
This article is about the use of portals by patients who have at least some association with the portal provider and know, if and when they check, there will be information accessible that is likely to come directly from their carers and will be up-to-date and relevant to their care.
This is of course to be compared with the myHR portal which may, or may not, have any relevant information, may or may not be current and may or may not contain anything useful.
Again in this study the effects of education, health literacy, digital literacy, age and so it goes on. Sadly the ADHA seems to think that, when they suddenly give people a myHR they citizen will miraculously know how to both access and use it – which is clearly fantastical nonsense.
The bottom line is that few will bother with the myHR portal and those that do are likely to be overwhelmed by complexity and underwhelmed by the functionality and utility they are offered.
The public is simply not ready for delivery of health information digitally as pretty much the sole mode of access – and many probably never will be.
This really is not thought through about how the ADHA is going about its mandate of delivering Digital Health for all. There are going to be many left by the wayside I am sure – and that is just plain wrong.
Posted by Dr David G More MB PhD at Sunday, January 06, 2019