Publication Date: March 3, 2010
ATLANTA, GA—The American Medical Association (AMA) and the Markle Foundation joined together to conduct coordinated surveys that examine physician and patient views of electronic personal health records (PHRs). Selected results of these surveys are being presented today at the 2010 HIMSS Conference in Atlanta.
“Our surveys over the years have found that large numbers of consumers see the benefits of accessing their health information and connecting to health services online. Our work with the AMA validates that many doctors also see the potential of this rapidly evolving technology,” said Carol Diamond, MD, MPH, managing director at the Markle Foundation.
“By asking physicians and patients comparable questions about PHRs, we see that patients and physicians have some similar and some contrasting views. Members of both groups often agree on the potential of PHRs to help individual patients and their families better manage their care, but many doctors also express important concerns about PHR use, like privacy and accuracy of data,” said Matthew Wynia, MD, MPH, director of the Institute for Ethics at the AMA.
Four out of five Americans believe using an online PHR would provide major benefits to individuals in managing their health and health care services, with 86 percent or higher saying that PHRs could help them avoid duplicated tests, keep doctors informed, move more easily from doctor to doctor, check the accuracy of their medical records, and track personal health expenses.
While less than 20 percent of physicians have significant experience using PHRs, half agree that PHRs can “help empower patients to participate in their care” and 44 percent are willing to make use of PHRs as part of their clinical work.
Both patients and physicians cited privacy as a chief concern with PHRs. Of those surveyed, 87 to 92 percent of consumers said that privacy protection would factor into their decision to use an online PHR. Similarly, 70 percent of physicians agreed that PHRs may not have adequate privacy protections. Other concerns cited among physicians include the possibility that PHRs could contain inaccurate information (79 to 85 percent were concerned about this), create liability risks (76 percent), and that physicians would not be reimbursed for time spent reviewing PHRs (63 percent).
“The great majority of physicians haven’t used PHRs yet, so these concerns reflect expectations more than current practice,” Dr. Wynia said. “These surveys can help us understand and proactively address physicians’ and patients’ hopes and concerns about PHRs, which is critical to moving forward and using these new tools effectively,” said Dr. Wynia.
“Today’s presentation provides some interesting glimpses into attitudes among doctors and the public as health IT tools become more widespread, and much more study is needed,” said Josh Lemieux, director of personal health technology at Markle. “It’s increasingly important to understand how individuals use the Internet to pull together copies of their health information, generate new information about themselves such as with home monitoring devices, and share electronic information with doctors in order to make more informed health decisions.”
The Markle Survey of Consumers
The questionnaire was developed by Professor Alan F. Westin and Josh Lemieux of the Markle Foundation, with inputs from the Markle staff and Dr. Wynia. Knowledge Networks created a national sample of 1,580 respondents representative of the total adult (19+) US population (estimated at 228 million), covering both persons who use the Internet and those who do not. Responses were collected by a special online process between May 13 and 22, 2008. Knowledge Networks places the error rate for this sample at ±2.5 percent.
The AMA Survey of Physicians
The survey was developed through collaboration between the Institute for Ethics and AMA Health Information Technology Initiatives, with funding from the Markle Foundation. Results are derived from a national survey in 2008–09 of patient-care physicians, with oversampling of OB/GYNs and psychiatrists. The analysis is based on 856 respondents (response rate: 52.1 percent) and is weighted to reflect the general population of physicians. The figure of 44 percent willingness to use PHRs is also statistically adjusted to account for variations in physician specialty, gender, and other demographic variables (the unadjusted value is 42 percent).