Technical limitations are inhibiting consumers’ access to personal health records, moreso than their willingness to use technology.

Current PHRs have limited utility and don’t incorporate enough user-friendly consumer technologies to enable easy access, contends Eric Ford, professor and associate chair of the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.

Overcoming these limitations, and taking full advantage of the many ways by which consumers could access their health records, could facilitate PHR adoption, argues Ford and researchers from the National Cancer Institute and Ohio State University College of Medicine in a recently published study.

Eric Ford
Eric Ford

“Full patient access to their EHR-tethered portal or personally controlled PHR has been slow historically,” concludes their study, published in the Journal of Medical Internet Research, which evaluates data from the annual Health Information National Trends Survey (HINTS) to assess current consumer use of web-based apps to store personal health information and communicate with providers.

Health IT vendors and providers are limiting PHR functionality instead of adopting higher-level capabilities available in apps offered to consumers by other industries, Ford contends. In fact, people who use personal health tracking tools say they’re much better and more usable than current PHRs, he adds.

“Every provider that a patient sees has a different portal, so patients have to maintain five or six different entry points to their information,” Ford says. “In the financial services industry, however, there are products that allow you to pull in all your credit cards and bank accounts as part of an information aggregator.”

Nonetheless, he believes the proliferation of open application programming interfaces (APIs) could energize the development of a new breed of third-party health data apps for providers and patients, which would facilitate information sharing.

“There are a lot of companies out there that, if they want to, have the competencies to go into an API and then build a front-end platform that takes in data and organizes it in a very usable, consumer-facing way.”

However, other barriers to PHR adoption must be overcome, Ford says. For example, Meaningful Use goals established by the federal government to drive the use of PHRs by consumers are not very ambitious, and Stage 3 objectives have thresholds for consumer engagement that are only incrementally higher than Stage 2. The percentage of consumers who must communicate electronically with their provider in Stage 3 is set at 10 percent, compared with 5 percent under Stage 2, Ford says.

Nonetheless, he is encouraged by the fact that the MU Stage 3 final rule requires certified EHR technology to provide an API through which patients can have access to their data. “I think the vendors have resisted it for a long time because they were trying to hold that data very close and monetize it,” Ford concludes. “But, with the government pushing on this openness, it’s going to happen.”

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