As more and more consumers see their doctors using electronic health records (EHRs), trust in doctors is high and patients have confidence that health information technology (health IT) can improve the quality and coordination of care. Those with online access to their own medical records are especially supportive of health IT. But consumers have persistent concerns that data breaches will occur.
The federal government is providing incentives for the use of health IT right now, investing tens of billions of dollars in its adoption. Health IT is a foundation for health reform and for many of the new models of care now being developed or tested. At this key moment as health IT is being rolled out, the National Partnership for Women & Families commissioned an unprecedented study to examine consumer views on health IT with research directed by Alan Westin, Ph.D., professor emeritus at Columbia University. It was conducted by Harris Interactive.
“We fielded this survey now, in the early stages of the transformation to EHRs, to assess consumer views and to measure whether the ways doctors and hospitals are using them is what patients want and need,” said Christine Bechtel, vice president at the National Partnership. Bechtel also represents patients and families on the federal Health IT Policy Committee. “For health IT to deliver on its promise, consumers must support it. If they don’t, we will see political pressure for repeal and the promise will be squandered. What we found is encouraging, but there are still potential landmines ahead.”
“This survey draws attention to a critical, but sometimes overlooked, facet of health information technology — patients and their families need to be at the center of efforts to modernize health care’s information infrastructure,” said Dr. Farzad Mostashari, National Coordinator for Health IT, U.S. Department of Health and Human Services.
Making IT Meaningful: How Consumers Value and Trust Health IT takes an unprecedented look at consumer confidence in health IT. Survey respondents had an ongoing relationship with a care provider and knew whether that provider uses an electronic or paper record system. Among the findings:
- Regardless of the type of record their physician uses, patients see value in EHRs. When asked if an EHR is or would be useful for seven key elements of care — such as making sure doctors have timely access to relevant information, and helping patients communicate directly with providers — 88 to 97 percent of those whose doctors use EHRs, and 80 to 97 percent of those whose doctors use paper medical records, said EHRs would be useful.
- Just six percent of respondents whose doctors use EHRs are unsatisfied with the medical record system their doctors are using.
- Three in four respondents whose doctors use paper records said it would be valuable if their doctors adopted EHRs.
- The one in four respondents who have online access to their medical records (26 percent) were even more supportive of health IT than those who do not, particularly when it comes to the ways in which EHRs benefit them personally. They were also more trusting of doctors to protect their privacy.
- Overwhelming majorities of respondents, regardless of record system, trust their doctors to protect the privacy of their health information.
- Consumers rated EHRs higher than paper records when it comes to giving patients confidence their information is safe, complying with privacy laws, giving patients more control over their health information, earning their trust, and seeing a record of who has accessed their information.
- There are concerns about data breaches and current privacy laws. Three in five respondents whose doctors use EHRs (59 percent) agree that widespread adoption of EHRs will lead to even more personal information being lost or stolen, as do 66 percent of respondents whose doctors use paper records. Similarly, more than half of those whose doctors use EHRs (51 percent) and 53 percent of those whose doctors use paper records agree that the privacy of personal medical records and personal health information is not currently well protected by federal and state laws and organizational practices.
- Those with paper records today who are most worried about their privacy in this survey were men, those with a college education, respondents ages 35 to 46, and those living in the east and west.
An oversample of Hispanic adults found that those whose doctors use EHRs were significantly more likely than others to see them as valuable in helping them personally in some important ways, such as maintaining a healthy lifestyle, understanding their health conditions and keeping up with their medications. At the same time, they were more likely both to report having experienced a data breach and to worry that more widespread adoption of EHRs will lead to even more such breaches.
“The survey shows that patients see tremendous value in the power of electronic health records to improve the way care is delivered by facilitating better communication and helping them become active partners in their own care. Its findings offer important messages about how to build, implement and use health IT systems in ways that are meaningful and beneficial to patients and their families,” Mostashari said.
“At the same time, patients are also saying the success of advanced information technology rests on a foundation of trust that must be vigilantly protected,” he added. “Encouraging the adoption and meaningful use of electronic health records is important, but the ultimate goal should be to leverage information technology in ways that lead to higher quality care, more coordinated care, and care that is truly patient-centered.”
“At a time when America’s taxpayers have made such a large investment in the implementation of health IT, we have an obligation to use their dollars wisely and get this right,” the National Partnership’s Bechtel said. “Amplifying the voices of consumers is key to success. This survey gives consumers a voice.”
The survey was conducted from August 3 to August 22, 2011. The respondent pool was 1,961 adults. It was funded by the Commonwealth Fund, Merck & Co., Inc., WellPoint, Inc. and the California HealthCare Foundation. It is intended to serve as a baseline for longitudinal tracking, and the survey instrument has been made available for public use.
The survey report includes a series of policy recommendations in the areas of consumer education, and functional and privacy requirements for a variety of federal programs.
NOTE: The new survey is available at www.NationalPartnership.org/HIT. As a leader of the Consumer Partnership for eHealth, the National Partnership published a Consumer Platform for Health IT last year; it is available here.