Evaluation of the Personal Health Record Pilot for Medicare Fee-For Service Enrollees from South Carolina. Suggestions for PHR Developers.

08/01/2009

Self-Entry of Information.  Generally, participants reported that they did not want to manually enter information into the PHR, as this was particularly time consuming for beneficiaries. 

“The crux is this system is only helpful if it has a lot of information from people other than us.  [Currently] it is depending on us entering information into MyPHRSC and few people will take the time to enter information and gather information from doctors to put in. The goal should be to aim at getting it from the Medicare system or health providers.”

Beneficiary

Medications and Decision Support.  Many beneficiaries suggested the PHR would be more useful to them if their medication data was entered for them.  One beneficiary explained: “I would like a complete list of medications, immunizations, and conditions that a doctor would have access to.”  Most beneficiaries also reported drug-drug and drug-allergy interactions checking would be very helpful for them.

Integration with Doctors.  The majority of beneficiaries believed the PHR would be the most valuable if doctors used it.  One participant noted: “If I have blood work with one doctor and a couple of weeks later I have an appointment with another doctor, it might be for the same test. One advantage to this is [provider] could look at the test and see the test had already been performed.”  Another beneficiary explained willingness to self-enter more information if doctors were to use the PHR.

The group discussed the potential benefit of having the PHR interact with an EHR and some thought this would be useful.  One participant commented, “It depends on interfacing with all of the providers. Having three of your providers enter information in the PHR and your 4th provider not use it, it would not work.”

Desired Amount of Information.  The majority of beneficiaries agreed that they would want as much information as possible at hand, with some noting that the full medical record would be of particular use to them. 

Conversely, when asked if they would want diagnostic results like an X-ray or MRI to appear in the PHR, the group was quite divided.  Some reported that they wanted all of their information available, while most agreed that this would be too overwhelming and they would prefer only targeted information be accessible.  Many felt comfortable with their doctors maintaining medical records with test results as an alternative.

Time span of Claims Information. Many participants suggested that 2 years of claims data was not a sufficient record for them and that they would like the history to go back further in the lifetime. A few suggested a lifespan history would be useful. 

Trending Laboratory Results.   Overall, participants would like to be able to see the results of their tests.  Many also noted they would want to track trends in their laboratory test results.  One participant explained, “If it showed you a string so you could see trends in things like cholesterol, blood sugar, and trends even your doctor doesn’t see, that would be useful.” 

Pay to Use the PHR.   Most beneficiaries reported they would pay for a PHR if it contained the functionalities and components most desired.  One participant commented: “If it was a valuable tool for me and my doctor to access, I would pay for it.” One beneficiary who was particularly enthusiastic about the PHR was unable to afford to pay for MyPHRSC but wanted to continue using it.

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