Predictors of electronic personal health record adoption among health care consumers: A case for “meaningful use” engagement (PART 1)


Published: April 14, 2014 by Dr. Lisa Daulby

Do you use a mobile app to track your health care information? Do you electronically exchange your health information with a health care provider? These are just some of the questions that were asked of US health care consumers in a recently conducted survey study on electronic personal health record adoption and use.

The Context
On February 17, 2009, the American Recovery and Reinvestment Act was enacted. The Act contained provisions for the Health Information Technology for Economic and Clinical Health Act (HITECH) which created funding opportunities for the implementation of electronic health record technologies. The purpose of HITECH’s financial stimulus and incentives were to increase the use of health care technologies to support government directives for a sophisticated electronic health data exchange program. The planned objectives of the Act are to protect the privacy and security of personal health information, improve public health, expand care coordination, engage patients and families, and advance health record quality and efficiencies. There is no mandate for health care providers to comply with the HITECH Act, yet large incentives are being offered to eligible professionals, hospitals, and critical access hospitals who exhibit “Meaningful Use” of certified electronic health record technologies.

The criteria for Meaningful Use are defined in a series of evolving stages. Meaningful use specific objectives for stages 1 and 2 provided eligible health care professionals and hospitals with incentives for capturing and sharing electronic health records. On March 11, 2014, the Meaningful Use Workgroup of the Health Information Technology Policy Committee published stage 3 draft recommendations for forthcoming Meaningful Use criteria for 2016 and beyond. One of the many Meaningful Use objectives for stage 3 is to achieve more patient-controlled access to self-management health care technologies with the specific objective to encourage health consumers to take a more active role in their health and the health of their families (Health, 2014). For example, one of the proposed rules for stage 3 meaningful use requires that eligible professionals and hospitals provide patients with the ability to view online, download, and transmit their electronic health information within 24 hours of a visit. Furthermore, providers may be required to receive and review patient generated health data and accept updates to their organizational/regional electronic health record systems.

Provider based electronic health records technologies have the capability of being shared across different health care settings through network-connected enterprise-wide information systems and other electronic health information exchanges. Functionality can be provided to allow patients to view their own health information which is stored physicians’, health plan providers’, hospitals’, and/or employers’ information systems. In addition, health data can be captured and stored by healthcare consumers on personally controlled, commercially available web based tools and/or mobile applications. A number of viable methods for health care consumer engagement exist for stage 3 meaningful use directives, however, is this what patients really want?

The Research
The use of electronic health record solutions, both provider-based and individually controlled, could foreseeably assist eligible professionals, hospitals, and critical access hospitals demonstrate compliance with meaningful use mandates. Yet, will heath care consumers readily adopt and use these tools? Do patients want to view online, download, transmit, and even update their personal heath data? Given recently published draft policy objectives for the engagement of patients and families in their own care, I recently set out to address these questions as a component of my doctoral work. The intent of the research was to provide information about health care consumers’ perception of electronic personal health records and their intention to adopt them for personal individual purposes and or to share with providers exclusively or within an electronic health information exchange. The research utilized a non-experimental, quantitative research design. A web-based, self-administered in-depth survey was conducted against a randomly selected population of English speaking/reading adults residing in the United States (U.S). It is believed that the insights gained from this research will be of importance to health care providers, organizations, and policy makers given the potential for electronic health record adoption and use under HITECH’s meaningful use policies. The data collected is currently being analyzed.

Return for Part 2 – Results of this research will be published here within the forthcoming months.

American Recovery and Reinvestment Act of 2009, H. R. 112—165, 111th Cong. (2009).


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