I was chatting to a GP friend on Saturday night at a Royal Tennis presentation dinner [at which, wonder of wonders, I picked up a minor trophy], and was fascinated by her suggestion that one reason patients haven’t been active participants in their healthcare is that in too many cases they believe that they can treat their bodies as they please [not playing regular bouts of Royal Tennis for instance], and that it’s the GP’s job to keep them healthy.
I was reminded of that this morning when I read a piece by Information Week columnist Paul Cerrato, suggesting that the main reason the public doesn’t sign up for personal health records is: “They don’t really care that much about their health”.
Cerrato says concerns about security and privacy and the reluctance of providers to share patient information don’t help, but “at its core this is about apathy”. His view is that my GP friend is correct:
Most Americans care more about their cars than their health. They know more about automotive specs than they do about physiological specs. Similarly, most people want to see a doctor only when something breaks down, and then they expect a pill or procedure to make things right, just as they expect their car mechanic to fix their cars. Healthcare for most Americans is about having someone else “make it better,” not about personal responsibility.
His view, however, is that we shouldn’t give up on electronic health records, despite the fact that research indicates only roughly 10 per cent of patients use them.
There are signs, he suggests, that that figure can be greatly improved.
The Dossia Consortium, for instance – a co-operative effort by companies including AT&T, Intel, and Walmart aimed at encouraging employees to become more active in their own healthcare, largely because healthier employees lead to lower employer and employee healthcare costs - has seen some of its members enrolling as many as 80 per cent. of employees.
Then there’s the Continua Health Alliance, which is working to create a system of interoperable personal connected health solutions and extend them to the home.
“A lot depends on how much the client company promotes the service and the kinds of incentives it provides employees,” says Cerrato.
I hope the government keeps that in mind, as the target date for availability of Australia’s PCEHR rapidly approaches.
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This is precisely why the PCEHR needs to be as accessible as possible. If it’s yet another federal government system that plays mind games with you every time you try to login, it will be a big fat failure. Yet I can’t see the federal government doing something so mainstream and blindingly obvious as providing authentication via OAuth providers such as Facebook and Google.
Apathy and lack of consumer involvement in eHealth care is a major problem. However, it’s not surprising given current approaches to eHR and eHealth. Without the ability to participate in decisions that influence their health, there’s little incentive for consumers to simply provide health information. Accessing and providing information requires effort. One could not expect consumers to do that, unless they could make use of that information.
This applies elsewhere. For example, online banking wouldn’t be as popular, or in fact useful, if all one could do is check the account balance without having the ability to take action – transfer money, pay bills, invest, etc. Also, how useful would it be to view information about products online without actually being able to purchase them?!
The PCEHR is a great initiative. With its release comes a real opportunity for the Government (NEHTA) to support early consumer integration into this system. Maybe this will reduce apathy, and further motivate consumer engagement, leading to improved health outcomes at reduced costs.
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