More people signing up for e-patient records, but widespread use low

The number of citizens using personal health records has doubled during the past two years, but only 7 percent have chosen to use the digital files to manage their health information, according to a survey released on Tuesday.

In addition, 75 percent of respondents said they still are skeptical about how safe their private medical information would be in an electronic health record, and many expressed concern that the data could be accessed by their employers and health insurance plans, reported the California HealthCare Foundation, which studies health care delivery, financing and access to information.

One-third of the 1,849 citizens surveyed said they would consider hiding some medical information from their health provider because of those fears, according to the report.

Personal health records are defined as medical files an individual manages and controls, while electronic health records contain information that a doctor oversees and can electronically feed into personal health records. Some health care providers and insurance companies offer patients personal health records, and technology giants Google and Microsoft Corp. also offer the public the ability to store their personal health records online.

"Most health care is self-care, since most people only see their physicians periodically," said Mark Smith, president and chief executive officer of the foundation. The survey showed that "when individuals have easy access to their health information, they pay greater attention to their health. And for the first time, the survey documents that PHRs empower some people -- including some of the heaviest users of the health system -- to take better care of themselves."

The survey reinforces the self-care concept and provided the Health and Human Services Department with insights into why patients choose to use personal health records, Joshua Seidman, acting director of the Meaningful Use Division for the National Coordinator for Health Information Technology at HHS, told reporters on Monday.

The survey found 64 percent of respondents who had a personal health record said the biggest advantage was the ability to check online the accuracy of their medical information, and 57 percent said the best feature was the ability to view test results. More than half (52 percent) said the chance to renew prescriptions online was the most useful feature.

A major initiative in the Obama administration is the expansion of electronic health records. The Recovery Act provides payments of up to $44,000 to clinicians who adopt electronic health records that meet the government's yet-to-be-determined definition of meaningful use. Seidman said the kind of patient engagement provided by personal health records is one of the top priorities of the meaningful use standards.

Deborah Peel, founder of Patient Privacy Rights, an advocacy group in Austin, Texas, that works to ensure medical information remains confidential, said the survey reinforced the public's concern that electronic medical information might not be secure. But she criticized the survey for not defining privacy -- the individual's right to control personal health information -- or confidentiality.

Peel also faulted the survey for trying to sell the use of personal health records to respondents by "extolling the many benefits [of the records] and minimizing or omitting all the very real risks."

Other criticisms included comparing the use of personal health records to the risks of online banking, which Peel called a poor analogy because far fewer people have access to an individual's financial records than those who have access to a patient's record. She added the survey also did not warn respondents that some personal health records can be data mined for health studies and the information sold.

Despite a two-year effort by Google and Microsoft to push the use of their personal health record platforms -- Google Health and Microsoft HealthVault -- the survey found only 25 percent of citizens would choose to sign up for either of those services. Respondents said they preferred to use health records provided by doctors and hospitals (58 percent) or insurance plans (50 percent), according to the survey.

Personal health records hosted by providers, health plans or employers automatically populate data, "but they typically don't make it easy for patients to take their data with them or add other data outside of these hosted networks," a Google spokesman said. "That makes it frustrating to switch services when you have to move or change jobs, and difficult to work through a medical issue with multiple providers."

Microsoft officials did not respond to a request for comment on the survey.