WEDNESDAY, March 30 (HealthDay News) -- When it comes to taking
advantage of Internet-based medical information in the form of
physician-provided online "personal health records," some American
patients are more plugged in than others, new research reveals.
Differences in race, income and age all affect the likelihood
that patients will log on to check out their own health history,
the study shows, with patients who are white, older, and/or
wealthier more likely to request access to their online medical
"It's really probably just been in the last three or four years that usage has really begun to take off," noted study co-author Dr. David W. Bates, chief of the division of general internal medicine in the department of medicine at Brigham and Women's Hospital in Boston. "And it's growing very fast, and should continue to grow really rapidly. But the bottom-line is that a digital divide does exist in terms of who tends to start using online personal health records," Bates said.
"But the good news is that once people actually start using them, the level of use is basically the same for all patients, regardless of socioeconomic status and race," he added.
Bates, who is also the medical director of clinical and quality
analysis at Partners HealthCare System in Boston, and colleagues
report their findings in the March 28 issue of
Archives of Internal Medicine.
Personal health records are an Internet-based set of tools that
allow people to review lab-test results and communicate by email
with their health care providers, among other things.
The Obama administration and many health care advocates have
been pushing online medical records as a way to make health care
easier and more reliable, and the authors note that more than 70
million Americans are now estimated to have access to some form of
their online medical history.
That said, less than 10 percent of Americans appear to be using
electronic medical records, with almost half saying they're not
even clear if their doctor actually offers access, according to a
Harris Interactive/HealthDay survey of more than 2,000
The current investigation found that 43 percent of more than
75,000 patients living in the northeastern United States who had
been seen between 2007 and 2009 at a clinical practice that offered
personal health records had, in fact, signed up for (or "adopted")
access to their doctor's system.
But upon closer look, the personal health record sign-up picture
revealed considerable disparities. For example, blacks and
Hispanics were only half as likely to sign up for personal health
record access compared with white patients, the authors noted, and
the wealthiest patients were 14 percent more likely to initiate
personal health record use than the poorest patients.
Patients over the age of 65 were more likely to sign up than
those between 18 and 35, as were those juggling more than one
serious health issue. However, those who visited their doctor with
greater regularity were actually less likely to sign up for
personal health record access.
Among those who did sign up for access, just over half were
categorized as "very low users" (logging in once at most in the
prior two years), while a little over one-quarter were deemed "high
users" (logging in 10 or more times).
Older patients, between the ages of 51 and 65, constituted the
largest slice of the high-user group, they found, accounting for
four in 10 among such patients.
But other personal health record usage patterns tell a more
For example, income level had no effect on how much patients
used the system once they were signed up. Similarly, although
seeing a physician more often was linked to lower sign-up rates, it
was also linked to higher personal health record use rates among
Among those who accessed personal health records, 70 percent
made use of the system's patient-physician messaging feature
infrequently. Among those who did, questions about care and
requests for drug refills were the most popular subjects, each
accounting for about one-third of messaging. Doctor referrals was
another popular messaging topic, followed by address corrections
Bates and his associates were unable to say exactly what seems
to be driving the differences in personal health record adoption
and use, calling for more research on the subject.
"But there's already increasing evidence that using an online health record like this should improve the patient experience and quality of care," Bates said. "It's just very helpful to go and look at your lab tests at your leisure. And most providers believe that it's really to the patient's advantage to be more informed about the care they're getting," he added.
"So it's important to figure out why a lot of people haven't been doing this yet," Bates said.
Meanwhile, Erin Stevenson, a senior digital health care
consultant for Redwood Medical Consulting in Bayside, Calif., sees
a bright future for online personal health records, despite some
"Twentysomethings tend to take their health for granted and have better things to do, so they're not using it a lot. And poverty, which often mixes with race, is a predominant reason people don't log on, because folks who are busy and focused on just scraping by and surviving see it as a luxury they just can't swing," Stevenson observed.
"So it's the middle and upper classes, and folks who are 30 and up who are serious about their health who are using this to begin with," Stevenson noted. "It gets tricky among those mid-50s and up, because then you get into people who are not very computer literate. But people who do use it report back to their doctors that they like it. And word of mouth matters. So really we're probably going to see use going up, even doubling among the plus-30 folks over the next two to three years, as people start talking about the portal process to their friends."
For more on electronic health records, visit the
U.S. Centers for Disease Control and
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