Evaluation of the Personal Health Record Pilot for Medicare Fee-For Service Enrollees from South Carolina. Integration of MyPHRSC into Beneficiaries' Health Information Management

08/01/2009

Overall, it did not appear that MyPHRSC had a great effect on how beneficiaries manage their health information. Primarily, the PHR seemed to be viewed as a source of supplemental information and not as a replacement for beneficiaries’ current health records. For instance, while the Wallet Card replaced a couple of participants’ previous lists, others—even the most tech-savvy—preferred to maintain their old system because it was what they had found could work for them.

Beneficiaries were able to see situations in which MyPHRSC would become more integrated into their health information management. Most of the participants appeared to be permanently settled in the Columbia area, but one indicated that if planning to move, the PHR would help with the transition to a new doctor. There were important examples of the PHR influencing beneficiaries’ interactions with their doctors. One beneficiary experienced seeing a new doctor whose information conflicted with a previous provider about the appropriate treatment for the diagnosis. Upon questioning the new physician about the difference, the physician asked the beneficiary to describe everything that had happened in relation to the diagnosis. The beneficiary used MyPHRSC to develop a chronological list of everything that occurred in relation to this diagnosis.

Most Useful Functions in MyPHRSC. Users perceived greater value in some MyPHRSC functions than others. In order of preference, the Wallet Card, Health Record Summary and Claims history features were identified as being the most useful features. Beneficiaries appreciated the portability of the Wallet Card, perceiving it as a particularly convenient way to share information with providers and touting the importance of having the emergency contact information at hand. The Wallet Card’s tremendous potential to improve the quality of communication between participants and their providers as well as enhancing the doctor-patient relationship was also mentioned.

The Claims feature of MyPHRSC was cited as a useful tool to help beneficiaries keep track of finances. It also gave some details helpful to beneficiaries, such as the name of the provider associated with the claim and the status of the claim. The Health Record Summary was also perceived as useful. Beneficiaries were impressed with the thoroughness and the extent of detail available with the summary.

In terms of other MyPHRSC features, the Medications component of MyPHRSC was reported by beneficiaries as a highly desirable function of the PHR. Beneficiaries reported that the current Medications page was cumbersome to use, but that tracking medications through the PHR is highly desirable for helping beneficiaries to reconcile their medications over time.

Least Useful Functions in MyPHRSC.  The health calendar feature was cited as being less useful than some of the other MyPHRSC features. Beneficiaries found the calendar to be redundant and less accessible than paper calendars such as those that might easily be seen on a refrigerator and showing more than health-related appointments.

Improved Patient-Provider Communication. The PHR’s potential to facilitate dialogue with providers was highlighted by several beneficiaries. The Wallet Card in particular was reported to have enhanced communication between beneficiaries and their providers. The card contributed to improving the quality of dialogue by bringing the beneficiaries’ attention to issues in need of discussion with their provider. This provided the beneficiaries with an opportunity to further engage in their healthcare.

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