When it comes to patients managing their health information on the web, a new survey is indicating that there is a gap between what they want and what they know is available. The survey, from the New York City-based consulting firm Accenture found that while 90 percent of respondents want to self-manage their healthcare using technology, nearly half (46 percent) are unaware if their health records are available electronically.
This disconnect, according to Kaveh Safavi, M.D., who leads Accenture’s North American health industry group, happens because of two different reasons. One, he says, is because the access to this kind of information doesn’t exist yet. The other is that the access exists, but healthcare providers have not done a good enough job to make patients aware of it. Reasons aside, the perception from the general public is that while they desire this kind of information, it’s not there for them, he says.
“Patients’ appetite for access and self management is far ahead of our current ability and probably our willingness to provide patients with this kinds of access. The organizations that figure out how to get there quickly are likely to find a more loyal and more satisfied patient base than those who hold out,” Dr. Safavi says in an exclusive interview with HCI.
The survey of 1,100 U.S. patients found that one-third (33 percent) of respondents did not know whether services such as bill pay, electronic reminders, and lab results were available to them online.
Kaveh Safavi, M.D.
Self-Manage or Doctor-Manage?
That gap between what patients want and what they know wasn’t the only disconnect the Accenture survey uncovered when it comes to their perspectives on their own online information engagement. There is also a split between those who want their doctors to manage their medical records (48 percent) and those who prefer to manage their own information (44 percent).
Most traditional patient portals, Safavi says, are a doctor-controlled method of giving patients access to their health information. As he says, patients may not see the information as it was created, but it gives them a view nonetheless. A more open environment, such as the Open Notes project in Boston, aims to give patients an unfiltered view of their patient record.
“There’s always a little bit of skepticism when you ask to see your record, and what you’re given is what you know to be an edited summary of your record,” Safavi says. “Imagine if you asked to get your chart, and what you got instead what a summary report of your chart. It’s the same kind of thing. What you’re seeing is the beginning of a discussion about whether patients should have a direct view into the same record [as their doctor].”
Comparison to Other Industries
Like other sectors of business that have gone online, such as banking or retail, healthcare is looked at by consumers as a potential business on the web. Seventy-three percent of respondents want to be able to fill out prescriptions through mobile devices, while 72 percent would like to do it on the web. An overwhelming majority (88 percent) want to receive email reminders when it is time for preventative or follow-up care and three-quarters (76 percent) want the option of email consultations with doctors.
“Do-it-yourself has been a model for other businesses, and there has always been a couple of motivations for it,” Safavi says. “Part of it is the business motivation, if I allow people to go online and do this work; that actually reduces the costs of doing business. For the patients, they get control when they will have interaction–they don’t have to wait for specific hours on the phone. That level of self control is very empowering in many people’s lives.”
This doesn’t mean patients want to stop interacting with their doctor. That’s far from the case. In fact, while respondents want to increase access to health information through digital channels, the majority of those surveyed (85 percent) also want to preserve their in-person interactions with doctors when needed.
In terms of privacy and ease-of-use, Safavi says Accenture found that patients have the same expectations in managing their healthcare information online, as they would with any other industry. Furthermore, the same privacy protections you have through paper-based medical records, they expect with electronic records. He also says they want electronic records to have the right level of protection without being so cumbersome that they are unusable.
“It has to be consistent with the rest of their online experience,” Safavi says. “Many patients would say, ‘I have the same expectations with my money records, why are there hurdles for my patient records that I don’t have to go through with my online banking portal.’ The online banking portal has a sophisticated level of safety in the background that knows it’s you and you’ve been there, and questions are not asked over again if you’re working from the same computer. The expectation is the same kind of security appears in their health information.”