The results of a recent survey conducted by Johns Hopkins University, Brigham and Women's Hospital, and CVS Health point to a clear conclusion: It is time to give more than lip service to finding a mutually agreeable way for patients and their providers to communicate electronically beyond “official” platforms such as EHRs and patient portals.
The survey, which gauged patient use of, and interest in, using email, provider websites, and social media – specifically Facebook – was published in the Journal of General Internal Medicine.
“The easy answer is there are takeaways for everyone,” lead author Joy Lee, a post-doctoral research fellow at the Bloomberg School of Public Health at Johns Hopkins, told Health Data Management about her team's findings, “but especially for healthcare organizations like hospitals, and then providers. For hospitals and clinics, an important finding is pointing out the realization that demand is there – yes, there are concerns about data security, but this is right now an unmet need.”
While Lee said implications of the survey, which was funded by CVS Health, did not reach to the level of modifying macro-level policy, notably HIPAA, she did say the generally restrictive attitude provider organizations take toward direct communication with patients over “un-official” channels needs to be addressed.
“A lot of hospitals have pretty strict rules for how providers are supposed to use social media, and protecting professional boundaries – that's fine – but how do we meet this need? Something needs to change.”
For individual providers, Lee said the survey results point to a need to have a conversation about ways to start communicating electronically sooner rather than later.
“On a very practical level, a big takeaway they can have is to have that conversation with their patients – ‘How do you prefer to communicate electronically? Do you want to use email, do you want to use Facebook?’” Lee said. “I think it's a two-way street. I think we can begin to have this conversation to consider not just face-to-face interaction, but how do you as a patient and how do I as a provider prefer to use these technologies and how do we find a mutual common ground?”
Lee said she was most surprised by the percentage of the 2,252 survey respondents – 18 percent – who said they had used Facebook to communicate with their physician in the preceding six months. She also said that percentage could likely rise among most age demographics, especially older adults.
“We expected some people would have said they used Facebook, but 18 percent seemed higher than I would have expected, and yes, we expected some kind of age gradient, but the fact that even among the 65 and older demographic, I think 7 percent said they had used Facebook, and that really surprised me. So population-wise, I think more and more people 65 and older will be on Facebook - it's more of the adult platform for social media, so that number may very well increase.”
She also said the great discrepancy between the percentage of respondents who said they wanted access to online tools to manage their health (57 percent) and those who had actually done so (7 percent) pointed to a significant issue with current patient-facing technologies in EHRs.
“I think EHRs could be the solution, but at this point it isn't being communicated or rolled out to patients,” Lee said. “Either they are not being educated or it's not easy enough to use, and people are looking for these workarounds with email.”
Overall, to illustrate that point, 37 percent of respondents said they had used email to contact their physicians, with the highest use (49 percent) among 25-44 year-olds.
Lee said the next step for her research will be to study the issue from the providers’ side.
“This survey was all about the patients' use. We know patients have contacted their doctors, but we don’t know if the doctors actually accepted the friend request or did anything on their end,” she said. “Because the issues of boundaries and professionalism are on the physicians' side, we are interested in learning about how they are using, and how they can best be using, social media and communications technology.”
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