PHR's: the Apple Newton of our Times

Personal Health Records (PHRs) have been around long enough now that utilization studies are starting to emerge and the data isn’t good.  While we have increased physician adoption of EMRs and PHRs by offering incentives (soon to be disincentives) healthcare consumers are not participating.  A recent study conducted in the US highlighted that only one in 10 American’s had a personal health record and only about 50 percent of those questioned even knew what a PHR was. 

If the current offering of PHRs were a commercial product aimed at consumers (rather than healthcare professionals) they would have been pulled off the shelf ages ago.  Think Apple Newton (circa 1993). The problem with the Newton wasn’t any physical or technical problem. The problem that broke the Newton was that nobody was prepared for it.  There was no mental slot in people’s heads that the Newton could glide into.  Consumers are willing to overlook technical glitches if they have a firm grasp of what a product is and what it’s supposed to do. 

Why aren’t consumers taking advantage of all this development in the PHR world?  Healthcare Global looked into why patients are reluctant to embrace PHRs. 

Technological issues include

• Concerns about personal health record privacy
• The availability of personal health information in an emergency situation
• The notion that the health care industry's adoption of information technology lags far behind industries such as insurance and banking

Philosophical issues include

• The process of gathering personal health records is a complicated and cumbersome one that could take years
• Healthy patients who infrequently visit a doctor have little ePHI to begin with and, so the argument goes, have no interest in managing ePHI
• Physicians are not promoting them

 All of these issues make sense and Healthcare Global concluded from this information that that “the real spur in adoption will have to come from physician engagement and encouragement”.

Does this make sense to anyone?  With all the incentives and physician engagement, the solution to the issues identified by consumers is to engage with physicians more?  From what I can glean from the above issues, the focus needs to be on patient engagement, not physician. 

 Let’s try incenting consumer uptake by giving people a simple format to handle their personal health information that provides value and is actually fun and rewarding.   One approach is through gamification.  Carwyn Jones and Faisal Ahmed recently published an article in Pharmaphorum on gamification and defined it this way, "Gamification is an approach to learning, not a technological initiative in itself. True, gamification is a way of using technology to be more engaging; but it does this by giving the user certain actions to complete in return for rewards." 

Andrew Cantella a student at the University of Denver wrote a forward looking piece Playing for Your Life posted on the NaviNet Website last year. In his article he theorizes that gamification used to increase patient engagement should improve outcomes.    “If a progress bar, point system, or even simple animations were added to one’s treatment plan, an increase in engagement–subliminal or conscious–should result.”  This is the same logic being applied to the quantified-self movement flooding the market with physical activities trackers (and other monitoring devices). 

There are lots of interesting approaches out there to engage consumers.  Let’s stop focusing on the healthcare professionals and start engaging consumers, because without consumer participation, personal health records won’t accomplish anything. 

It’s your health.  It’s your health information.  Manage it well.