Security, Lack of Human Connection Leave Patients Wary of EHRs: Study

Only 26 percent of patients want to see their medical records go digital, a Harris Interactive report for Xerox revealed. Researchers say that more has to be done to educate patients about the benefits of digital health records.

Although doctors are showing interest in using electronic health records€”likely due to federal financial incentives€”only 26 percent of patients want to see EHRs used, according to research by Harris Interactive commissioned by Xerox.

Among respondents, 85 percent of patients expressed concern about digital medical records, Xerox reported.

For the third annual EHR online survey, Harris interviewed 2,147 U.S. adults in May 2012.

The number of respondents who indicated that they believed EHRs would improve care has held steady for the past three years at around 40 percent, according to the July 31 report.

John Moore, an analyst at Chilmark Research, had contrasting findings: "Consumers are not wary of their doctors using digital means to record health histories," he told eWEEK in an email. "In fact, most actually believe that they will receive better care€”perception issue€”if a doctor is using modern technology such as EHRs."

To improve patients' comfort with EHRs, education is key, according to Markus Fromherz, Xerox's chief innovation officer for health care.

"Education would be an important part of understanding how usually electronic health records are behind the firewalls of a hospital€”that they're as secure as financial information, the bank account," Fromherz told eWEEK.

"Consumers are very concerned about security of their PHI [protected health information] and have every right to be," said Moore. "This industry has an atrocious record when it comes to securing PHI, and thankfully, the feds are finally getting serious about enforcement."

Negative press from health care data breaches may be contributing to patients' EHR concerns, according to Nancy Fabozzi, principal analyst for health care at Frost & Sullivan. "But I think these issues will subside with time," Fabozzi told eWEEK in an email. "We are still very early in the game for EHR use."

Privacy and security have long been known to increase patients' fear of EHRs. In its March 2011 report, CDW Healthcare found that 49 percent of patients surveyed believed EHRs would impact their privacy negatively.

Another issue patients have with EHRs is how doctors turn away to enter data on a PC. This practice can be obtrusive, said Fromherz. Mobile technology, such as tablets, has the potential to reduce this distraction, he noted.

"If there's one thing that this survey tells us, coupled with our own experiences, it's that you should never develop or deploy technology outside of the human context," Steve Hoover, CEO of Xerox's Palo Alto Research Center, said in a statement.

"Some patients may have had a negative experience with a provider using an EHR, for example when the provider seems to focus more on the computer than the patient," said Fabozzi.

"This has happened to me," she added. "It's a very alienating experience."

Patients may also need education on the benefits of EHRs, Fromherz suggested. The Xerox unit The Breakaway Group aids hospitals with training and adoption of EHRs.

Searching in a database instead of sorting through a stack of papers can be easier for providers. In addition, EHRs can lead to detection of allergies and drug interactions, Fromherz noted.

"Having that information available could save a life," said Fromherz.

"The digitization and exchange of data becomes more valuable with more participants," said Fabozzi, referring to a "network effect." Patients and consumers have yet to see the benefits of EHRs or personal health records (PHRs) because "we haven't reached that tipping point," she said.

Just as physicians are motivated by federal incentives to implement EHRs, patients may eventually be presented with similar incentives to use PHRs and self-manage their care, Fabozzi suggested.

The Xerox data on patients contrasts with the view of physicians in July 17 findings by the Centers for Disease Control and Prevention's National Center for Health Statistics. The CDC organization revealed that 75 percent of physicians surveyed believed that their adoption of EHRs led to improved care.

"Doctors do not 'have religion' when it comes to adopting EHRs," said Moore. "It has simply become a necessary evil. They need to adopt EHRs of one form or another to remain competitive long term."

At PARC, Xerox is developing ways that EHRs can simplify back-office and frontline processes as well as reduce medical errors.

In fact, Harvard researchers found that 84 percent of doctors they interviewed for a recent study would likely face fewer malpractice claims after using EHRs. The report was published June 25 by the Archives of Internal Medicine.