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
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.