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Personal Health Record Adoption Rates Exceed MU Requirements

Personal health record adoption is expected to reach nearly 75 percent by 2020, far surpassing what's expected in meaningful use patient engagement requirements.

Patient preferences for engagement tools, such as personal health records, may be outpacing meaningful use’s patient engagement requirements, according to a recent study published in the Journal of Medical Internet Research.

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The study, spearheaded by lead researcher Eric W. Ford, PhD, explored how patients use personal health records (PHRs), the patient-managed version of an EHR, and the rate at which they will adopt the technology.

Specifically, the study compared the calculated rate of PHR adoption to the patient engagement requirements in meaningful use. Although meaningful use requirements do not explicitly call for the adoption of a PHR, the researchers argue that several of the patient engagement requirements in the program segue nicely into PHR adoption.

Stage 3 MU recommendations… state that patients should be able to (1) communicate electronically using secure messaging, (2) access patient education materials on the Internet, (3) generate health data into their providers’ EHRs, and (4) view, download, and transmit their provider-managed EHRs,” the researchers explained. “Taken together, these requirements outline the basic functionalities of a consumer-managed personal health record (PHR).”

Overall, the researchers found that PHR adoption rates exceed what is required for patient engagement measures for meaningful use.

In total, 75 percent of consumers are expected to have adopted a PHR by 2020. Meaningful use, on the other hand, requires only five percent of patients to use patient engagement tools for Stage 2 Meaningful Use, and 10 percent for Stage 3 Meaningful Use.

These findings are notable, particularly considering their meaning for policymakers. The research team suggests that policymakers consult data regarding patterns in PHR adoption in order to set optimal benchmarks.

“Understanding the trajectory of PHR uptake by consumers is important for policy makers, providers, and technology vendors,” the research team explained. “For policy makers, setting PHR usage targets based on quantified estimates rather than normative goals will ensure that targets are set at optimal levels to accelerate uptake, but not be unachievable.”

In fact, the research team suggests that meaningful use’s slower adoption model, which is determined by a lower adoption coefficient, is doing more harm than good with regard to PHR adoption by slowing technological innovation.

First, health information technology system vendors and providers may be making the minimum PHR functionalities available instead of adopting the higher-level capabilities available in nonclinical contexts that attract consumers to engage with these tools,” the research team stated.

In other words, because technology developers do not have high PHR adoption goals through meaningful use patient engagement requirements, they are not innovating these technologies as quickly as they could be.

Lower PHR adoption benchmarks may also be creating inadvertent bureaucratic barriers.

“Care providers may be creating barriers to technology adoption through bureaucratic and administrative burden, although most have attested to exceeding the MU standards,” the team said. Because the meaningful use requirements are set up with lower adoption expectations, there may be red tape in the way of effectively and efficiently using a PHR.

“MU goals on this issue may have the same problems in PHR adoption that they experienced in EHR adoption: the standards of engagement are low enough to allow for incremental approaches to adoption as opposed to incentivizing transformative targets,” the researchers explained.

Going forward, the researchers suggest policymakers explore various options for incentivizing greater innovation for PHRs, and take into account models for PHR adoption rates that facilitate robust adoption of the technology that is still achievable.

By both creating tools that are more user-focused and high-functioning and creating a system that rewards higher adoption of PHRs, healthcare professionals should be able to create an industry filled with strong patient engagement through health IT.