Healthcare Consumers’ Attitudes Towards Physician and Personal Use of Health Information Exchange
- 434 Downloads
Health information exchange (HIE), the electronic transmission of patient medical information across healthcare institutions, is on the forefront of the national agenda for healthcare reform. As healthcare consumers are critical participants in HIE, understanding their attitudes toward HIE is essential.
To determine healthcare consumers’ attitudes toward physician and personal use of HIE, and factors associated with their attitudes.
Cross-sectional telephone survey.
English-speaking residents of the Hudson Valley of New York.
Consumer reported attitudes towards HIE.
Of 199 eligible residents contacted, 170 (85%) completed the survey: 67% supported physician HIE use and 58% reported interest in using HIE themselves. Multivariate analysis suggested supporters of physician HIE were more likely to be caregivers for chronically ill individuals (OR 4.6, 95% CI 1.06, 19.6), earn more than $100,000 yearly (OR 3.5, 95% CI 1.2, 10.0), and believe physician HIE would improve the privacy and security of their medical records (OR 2.9, 95% CI 1.05, 7.9). Respondents interested in using personal HIE were less likely to be female (OR 0.4, 95% CI 0.1, 0.98), and more likely to be frequent Internet-users (OR 3.3, 95% CI 1.03, 10.6), feel communication among their physicians was inadequate (OR 6.7, 95% CI 1.7, 25.3), and believe personal HIE use would improve communication with their physicians (OR 4.7, 95% CI 1.7, 12.8).
Consumer outreach to gain further support for ongoing personal and physician HIE efforts is needed and should address consumer security concerns and potential disparities in HIE acceptance and use.
KEY WORDSconsumers health information exchange personal health records medical informatics survey research
The Taconic Independent Practice Association funded this work through a grant to Weill Cornell Medical College. Dr. O’Donnell participated in this study as a fellow funded by the Department of Public Health at Weill Cornell Medical College.
The authors would like to thank Rachel Block, Curt Cole, MD, Lori Evans, MPP, MPH, Ellen Flink, MBA, Gil Kuperman, MD, Akshay Kapur, Alex Low, Jason Shapiro, MD, and Adam Wilcox, PhD for their participation in the survey development workgroup. They would also like to thank Randolph Barrows Jr., MD, MS, John Blair, MD, Janlori Goldman, JD, and Art Levin for their input on the survey and Ken Griffin, PhD for his advice on survey methodology.
Conflicts of Interest
- 2.Walker J, Pan E, Johnston D, Adler-Milstein J, Bates DW, Middleton B. The value of health care information exchange and interoperability. Health Aff (Millwood). 2005 Jan-Jun;Suppl Web Exclusives:W5-10-W5-8.Google Scholar
- 3.Blumenthal D. Launching HITECH. N Engl J Med. Feb 4;362(5):382–5.Google Scholar
- 6.Gibbons MC, Wilson RF, Samal L, Lehmann CU, Dickersin K, Lehmann HP, Aboumatar H, Finkelstein J, Shelton E, Sharma R, Bass EB. Impact of consumer health informatics applications. Evidence report/technology assessment No. 188. (Prepared by Johns Hopkins University Evidence-based Practice Center under contract No. HHSA 290-2007-10061-I). AHRQ Publication No. 09(10)-E019. Rockville, MD: Agency for Healthcare Research and Quality; 2009.Google Scholar
- 7.Kaelber D, Pan EC. The value of personal health record (PHR) systems. AMIA Annu Symp Proc. 2008;343–7.Google Scholar
- 8.The Markle Foundation. Attitudes of Americans regarding personal health records and nationwide electronic health information exchange: key findings from two surveys of Americans, October, 2005. Available at: http://www.markle.org/sites/default/files/research_release_101105.pdf Accessed on April 19, 2011.
- 9.The Markle Foundation. Americans overwhelmingly believe electronic personal health records could improve their health, June, 2008. Available at: http://www.markle.org/sites/default/files/ResearchBrief-200806.pdf Accessed on April 19, 2011.
- 10.The Markle Foundation. Markle survey on health in a networked life 2010, Jan, 2011. Available at: http://www.markle.org/sites/default/files/20110110_HINLSurveyBrief_1.pdf Accessed on April 19, 2011.
- 11.Schneider S, Kerwin J, Robbins C, Dean D. Consumer engagement in developing electronic health information systems: final report. (Prepared by Westat, Rockville, Maryland, under Contract No. 233-02-0087). AHRQ Publication Number 09-0081-EFF. Rockville, MD: Agency for Healthcare Research and Quality; 2009.Google Scholar
- 13.The South Dakota e-Health Collaborative. Assessing the current state of electronic health records and health information exchange in South Dakota. Available at: http://www.tss.dsu.edu/sdehra/ Accessed on April 19, 2011.
- 14.CAHPS Clinician & Group Survey, Adult Primary Care Instrument. CAHPS clinician & group survey and reporting kit. Rockville MD: Agency for Healthcare Research and Quality. Updated 2008. Available at https://www.cahps.ahrq.gov/cahpskit/CG/CGChooseQX.asp. Accessed April 19, 2011.
- 16.Fiscal Policy Institute. The State of Working New York 2003: Regional Economic Profiles. Available at http://www.fiscalpolicy.org/archivepages/sowny_archive.html. Accessed on April 19, 2011.
- 17.The Computer Survey Methods Program at the University of California at Berkeley. Computer-Assisted Survey Execution System-CASES. Available at http://cases.berkeley.edu . Accessed on April 19, 2011.
- 18.Venkatesh V, Morris MG. User acceptance of information technology: toward a unified view. MIS Quarterly. 2003;23(3):425–78.Google Scholar
- 19.US Census Bureau. State and County Quick Facts: compiled from 2008, 2009 survey data. Available at http://quickfacts.census.gov. Accessed on April 19, 2011.
- 22.The California Healthcare Foundation. National Consumer Health Privacy Survey 2005. Available at: http://www.chcf.org/publications/2005/11/national-consumer-health-privacy-survey-2005 Accessed on April 19, 2011.
- 26.Wuerdeman L, Volk L, Pizziferri L, Tsurikova R, Harris C, Feygin R, Epstein M, Meyers K, Wald JS, Lansky D, Bates DW. How accurate is information that patients contribute to their electronic health record? AMIA Annu Symp Proc. 2005;834:8.Google Scholar
- 30.Smith V, Gifford K, Kramer S, Dalton J, MacTaggert P, Warner M. State E-Health Activities in 2007: Findings from a State Survey. The Commonwealth Fund, Pub no 1104. 2008.Google Scholar
- 32.Fox S. How gender influences health searches. PEW Internet & American Life Project, August 21, 2007. Available at http://www.pewInternet.org/Commentary/2007/August/How-Gender-Influences-Health-Searches.aspx Accessed on April 19, 2011.
- 35.Wen KY, Kreps G, Zhu F, Miller S. Consumers' perceptions about and use of the Internet for personal health records and health information exchange: analysis of the 2007 Health Information National Trends Survey. J Med Internet Res. 12(4):e73Google Scholar
- 36.Goldstein MM, Rein AL. Consumer consent options for electronic health information exchange: policy considerations and analysis. Prepared for the Office of the National Coordinator for Health IT. Washington, DC: George Washington University Medical Center; 2010.Google Scholar