Study: Barriers Remain to Including Daily Life Observations in PHRs
April 28, 2015 in News
While incorporating patients’ observations about daily life into their personal health records can be valuable for both patients and providers, barriers remain to integrating such data into typical clinical practice, according to an eight-year study conducted by the Robert Wood Johnson Foundation, Health Data Management reports.
For the study, RWJF in 2006 launched Project HealthDesign to explore patients’ personal health records as an engagement tool that can offer actionable information (Goedert, Health Data Management, 4/28).
The study, which concluded in June 2014, was conducted in two phases. Data from the first phase was released in 2009.
Last week, RWJF released a new report that included findings from the program’s first phase and second phase (RWJF report, 4/20).
First Phase of Study
For the first phase of the program, nine multidisciplinary teams created a PHR application that allowed users to manipulate data collected through a variety of platforms, including computers and mobile phones.
Among other things, researchers found that collecting observations of daily living helped consumers:
- Develop a more comprehensive health portrait;
- Engage in more productive conversations with physicians; and
- Make more informed health decisions (iHealthBeat, 6/22/09).
Researchers evaluating the first phase of the program also found that individuals were more interested in inputting their own descriptions of daily activity than having their electronic health record data be transmitted to their PHRs. In addition, researchers found that individuals who used PHRs considered having the ability to access and control their personal health data to be more important than privacy concerns (Health Data Management, 4/28).
Second Phase of Study
For the second phase of the program, organizations worked with consumers and physicians to examine the effectiveness of observations of daily living in improving chronic disease management (iHealthBeat, 6/22/09).
The researchers found:
- Current technologies allow for patients’ progress to be tracked with significantly more specificity compared with monthly or weekly office visits;
- Current technologies allow patients and providers to customize applications to select which data to record and how to present the information; and
- Nurses, health coaches and other non-physician providers tend to incorporate patient observations of daily living into clinical practice more than doctors.
However, the researchers also identified several barriers to integrating PHR data input by users into daily clinical practices, such as:
- Difficulty keeping up with technological innovations such as smartphone apps and various commercial personal health programs that included PHRs;
- Skepticism from doctors that having access to patient observations would lead to changes in patient behavior; and
- Providers being unwilling to allocate resources to adapt their health IT systems to accept patients’ observations of daily living, in part because of their focus on the meaningful use program.
Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments (Health Data Management, 4/28).