Personal Health Record Use in the United States: Forecasting Future Adoption Levels.
Personal Health Record Use in the United States: Forecasting Future Adoption Levels.
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DOI：
10.2196/jmir.4973
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发表时间：
2016-03-30
影响因子：
7.4
通讯作者：
Huerta TR
中科院分区：
文献类型：
--
作者：
Ford EW;Hesse BW;Huerta TR
个人健康记录（PHR）提供了一个巨大的机会，以获得消费者的支持，追求三重目标，降低成本，增加访问，提高护理质量。此外，美国的调查表明，消费者希望通过网络访问他们的医疗记录。然而，由于担心消费者的健康信息素养水平较低以及医生不愿分享笔记，将限制PHRs对相对较小部分人口的效用，因此减少了产品创新和政策必要性。我们的研究的目的是3倍：第一，报告美国消费者的PHR活动的当前水平;第二，描述模仿和创新的影响因素在确定PHR采用率的作用;第三，预测未来PHR扩散吸收美国消费者在3种情况下。我们使用了2008年、2011年和2013年美国公民健康信息全国趋势调查（HINTS）的二级数据。应用技术扩散理论和巴斯建模，我们评估了3个未来的PHR采用方案，通过不同的引进日期。所有模型都显示了特征扩散S曲线，表明PHR技术很可能在有意义的使用目标之前实现显著的市场渗透。表现最好的模型表明，到2020年，PHR的采用率将超过75%。因此，PHR采用的有意义使用计划目标低于在没有干预的情况下可能发生的比率。通过更好的消费者参与来提高护理质量和节省成本的承诺促使美国医学研究所在1999年呼吁普遍采用PHR。截至2014年，可获得的PHR产品可能会在2020年之前达到并超过有意义使用第三阶段的目标，而无需任何奖励。因此，应将更雄心勃勃的采用和功能可用性纳入未来目标。
Personal health records (PHRs) offer a tremendous opportunity to generate consumer support in pursing the triple aim of reducing costs, increasing access, and improving care quality. Moreover, surveys in the United States indicate that consumers want Web-based access to their medical records. However, concerns that consumers’ low health information literacy levels and physicians’ resistance to sharing notes will limit PHRs’ utility to a relatively small portion of the population have reduced both the product innovation and policy imperatives. The purpose of our study was 3-fold: first, to report on US consumers’ current level of PHR activity; second, to describe the roles of imitation and innovation influence factors in determining PHR adoption rates; and third, to forecast future PHR diffusion uptake among US consumers under 3 scenarios. We used secondary data from the Health Information National Trends Survey (HINTS) of US citizens for the survey years 2008, 2011, and 2013. Applying technology diffusion theory and Bass modeling, we evaluated 3 future PHR adoption scenarios by varying the introduction dates. All models displayed the characteristic diffusion S-curve indicating that the PHR technology is likely to achieve significant market penetration ahead of meaningful use goals. The best-performing model indicates that PHR adoption will exceed 75% by 2020. Therefore, the meaningful use program targets for PHR adoption are below the rates likely to occur without an intervention. The promise of improved care quality and cost savings through better consumer engagement prompted the US Institute of Medicine to call for universal PHR adoption in 1999. The PHR products available as of 2014 are likely to meet and exceed meaningful use stage 3 targets before 2020 without any incentive. Therefore, more ambitious uptake and functionality availability should be incorporated into future goals.