Evaluation of the Personal Health Record Pilot for Medicare Fee-For Service Enrollees from South Carolina. Outreach and Registration.


In order for PHRs to gain widespread adoption, consumers must be made aware of the availability and advantages of using this tool, and they must be taught how to use them.  After all, at the most basic level, an individual’s usage of PHRs depends on knowing what PHRs are and how they operate.  Although there were two major events that may have resulted in temporary spikes in beneficiary registration for MyPHRSC, many subsequent large events which included audiences of more than 100 did not correspond to spikes in registration. However, two small workshops with audiences of 19 and 35 seem to be linked to small increases beyond the average daily registration.  This suggests that smaller events, or workshops where beneficiaries are engaged one-on-one, may be more effective in encouraging registration. 

On the whole, there is insufficient data to determine the effectiveness of outreach activities on beneficiary registration for MyPHRSC.  While several specific outreach events appear to be linked to an uptake in beneficiary registrations on a particular day, there were substantially more outreach events that did not seem to be linked to any increase in registration for MyPHRSC.  It is possible that the outreach events linked to increased registrations on a particular day had beneficiaries register at the time of the event, while other outreach events may have relied on beneficiaries to register on their own at home at a later time.

The use of electronic or paper-based prompts, which were not a component of MyPHRSC outreach efforts, may help to remind beneficiaries about the tool and to encourage further use. Additionally, a referral from their physician, coupled with follow through communications (either face-to-face or by e-mail) may be likely to improve use of the tool.  It is also important to consider the potential impact of “viral marketing,” or marketing by word-of-mouth.  Referrals from friends, families, or providers may not be readily apparent in overall registration numbers as they can occur at any time, and are not easily identified as being tied to a specific outreach event. Future efforts to attempt to link outreach activities to beneficiary registration for MyPHRSC could be improved by requesting that beneficiaries report a referral source when registering.

Results of the data analysis also suggest that, while generating awareness of the existence of PHRs is certainly a critical first step, education alone is not adequate to ensure that consumers will adopt PHRs and use them on a regular basis. 

MyPHRSC Usage Over Time. The majority of beneficiaries who used MyPHRSC logged in during only one calendar month of the pilot.  While a substantial number of users logged in during two or three separate months, few users logged in during four or more separate months of the pilot.  Beneficiaries may not understand the value of continuing to log in to MyPHRSC to review their claims information over time, or may not find the content useful or compelling enough to continue to return to MyPHRSC after viewing it once or a handful of times.  Email messages or other reminders may be helpful in encouraging repeat use of MyPHRSC.  Such reminders could coincide with the addition of new information to MyPHRSC or could be generated if a specified time interval has passed without a beneficiary logging in.

In examining the general trends of MyPHRSC usage over time, it is clear that beneficiary use of the PHR drops off one or two months after they first registered. Experts have suggested repeated or regular use of PHRs as a key measure of the usefulness of the tool. At the same time, even a one-time visit to the PHR may signify usefulness and the decreased use of MyPHRSC over time do not necessarily mean that beneficiaries are not getting value from the tool. It may instead indicate that beneficiaries may have received the needed value during their initial use of the PHR and therefore do not have a need to return during the rest of that year. However, for many consumers, entering the data routinely and consistently, and printing it for future use (such as sharing with providers) serves a greater purpose.[53] 

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