Patient perceptions about health IT use are becoming more complicated, as health data security concerns, limited health and technology literacy, and differences in patient-provider viewpoints get in the way.
A recent Black Book survey of 12,090 adult patients found that 57 percent of healthcare consumers are skeptical of health IT use. That skepticism is primarily driven by health data security concerns.
Patients were most concerned that their pharmacy (90 percent), mental health (99 percent), and chronic condition (89 percent) data was sent to third parties such as the government, employers, and retailers. Ninety-three percent of patients were also concerned about the security of their financial information used in hospital billing departments.
As a result of these privacy concerns, few patients are willing to share all of their health information with their providers. Throughout 2016, eighty-nine percent of patients withheld part of their health data from their providers because of security concerns.
According to Doug Brown, Managing Partner of Black Book Market Research, patients who withhold information due to any concern can inhibit data analytics, resulting in limited population health management.
"Incomplete medical histories and undisclosed conditions, treatment or medications raises obvious concerns on the reliability and usefulness of patient health data in application of risk based analytics, care plans, modeling, payment reforms, and population health programming," said Brown.
"This revelation should force cybersecurity solutions to the top of the technology priorities in 2017 to achieve real trust in big data reliability."
The Black Book survey also showed that patients have difficulty using the patient portal, showing a need to improve patient health IT literacy.
Ninety-six percent of patients reported leaving their doctor’s office with limited knowledge of how to use the patient portal. Of the 40 percent of patients who said they had attempted to use the patient portal in 2016, eighty-three percent said it was too complicated to use.
Providers think it’s important to ensure patients are able to utilize the portal, the survey shows. Ninety-four percent of providers endorsed government-funded efforts to improve patient health literacy, ultimately boosting care outcomes and health IT use.
Brown says health IT developers should also design their tools to serve the lowest common denominator and allow the most vulnerable patients to understand and utilize the tools.
"With so many patients skeptical of the benefits of HIT, we must address that as we move forward. If not, we see progress that is not absorbed by the very constituents behind all the innovation to date," said Brown.
"The lack of health literacy is exacerbated in minority nonnative speakers, geriatrics, chronic care patients, and low income populations, the same populations being targeted by accountable care risk management."
Helpful to the cause are nurses, whose face-time with patients help them educate them about health IT use.
"We can attribute this to the role of technological education to patients that falls on nurses in large facilities,” said Brown. "The role of mediating between patients and technology usually falls on nurses because they have the appropriate culture and clinical background to perceive actual patient needs and literacy."
According to the survey, nurses practicing in larger hospitals (over 400 beds) have more luck educating patients than those in small hospitals (under 200 beds).
This is likely because nurses in larger hospitals are charged with the responsibility of educating patients about using the patient portal. Ninety-four percent of nurses in small hospitals say they don’t have the time factored into their workloads to perform this duty.
Going into 2017, healthcare professionals must also grapple with a disconnect between patient and provider perceptions about patient health IT use and patient-generated health data. While several patients expressed distrust in health IT security or lacked understanding in health IT use, a notable population is still interested in collaborating with providers about their health data.
Ninety-one percent of patients who use wearables think provider EHRs should collect all of that information.
However, most providers don’t feel the same. According to the survey, 94 percent of physicians find increased patient data redundant, overwhelming, and irrelevant to most clinical decisions.
And 82 percent of physicians say that patients with high health literacy and who use patient-facing IT collect both relevant and irrelevant health information. The increased information complicates appointments, requiring more discussion during diagnosis and often running appointments over time.
This disconnect is making it difficult for practices to meet patients’ health IT needs. Ninety-four percent of patients who use activity trackers said their doctor’s office didn’t have the ability or the desire to collect and store patient-generated health data in the EHR, and 98 percent of patients using nutrition apps said the same.
Eighty-eight percent of patients expressed frustration over the course of 2016 with their provider’s resistance to accommodating health IT requests, and 91 percent said they’d “felt slighted” by their providers in this regard. Going into 2017, 24 percent of those patients indicated they may change to providers who are more tech savvy.
According to Brown, this data shows increased health IT demands from patients.
"In this age of healthcare consumerism people want to receive care through technologically enabled alternatives like telemedicine visits, secure email communications with their practitioner, and access to records and scheduling," Brown said.
As patients become more engaged in their care and carry more purchasing power, providers must understand both patient wants and needs. Incorporating patient perceptions into patient engagement may be critical for an increasingly competitive healthcare market.