Patients may see greater access to their health records, but full adoption is still a few years out


Today, at the HIMSS 2013 conference, Accenture released initial U.S. findings from an eight-country physician survey measuring the global use of health information technology. The results provide insight into where doctors stand in the ongoing transition to electronic medical records. Of the more notable findings, 82% of doctors want patients to be able to update part of their electronic health records including histories of family illness or changes in demographic information, but 65% of those physicians think that patients shouldn’t have access to their full electronic health record.

An even more extreme contingent – 4% of survey participants said they thought patients shouldn’t have any access at all to their electronic health record. Accenture surveyed 3,700 doctors in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States. The concern for these physicians appears to be granting access to sensitive information like lab test results, which may be changed either mistakenly or maliciously.

image005Even though physicians may not want patients to be able to see and update all parts of their health record, nearly half of them (49%) say that providing access does improve care overall. Yet, only 21% of doctors surveyed currently allow patients to have online access to their medical summary or patient chart, the most basic form of a patient’s record.

“Many physicians believe that patients should take an active role in managing their own health information, because it fosters personal responsibility and ownership and enables both the patient and doctor to track progress outside scheduled appointments,” said Mark Knickrehm, global managing director of Accenture Health. “Several U.S. health systems have proven that the benefits outweigh the risks in allowing patients open access to their health records, and we expect this trend to continue.”

US doctors were the most open to letting patients make changes to their electronic health records including updates in changes of symptoms, side effects or the addition of new medications. Globally, physicians were a little more reticent.

Electronic health records have been one of the cornerstone technologies of the health IT revolution, often touted as a means of allowing doctors and patients to come to better health care outcomes through the efficiency of online data transfer and storage. However, getting doctors to adopt these systems has been difficult. As the former CEO of Allscripts, Glenn Tullman writes in a piece on Forbes today, electronic health records are some twenty years in the making. Survey data in the Accenture report shows that doctors still see it taking at least two more years before providers and patients see wide adoption of the technology.

Some big moves to push electronic health records have also seen equally large steps back, such as the announcement from the VA and the Department of Defense that they would scrap a plan to create a new, unified patient data system. VA Secretary Eric Shinseki and Former Secretary of Defense Leon Panetta announced in early February that they thought it would be faster and cheaper to work with the patchwork of IT and patient systems the two currently have. Today, Harris Corporation announced that it will be taking the lead on the integration.

Now, instead of a new system, Harris will use a service oriented architecture (SOA) to integrate legacy systems with new data sharing capabilities in a phased rollout starting in Texas and Virginia. This authorization from DoD is part of a multi-year, $80 million healthcare integration contract awarded to Harris in March 2012. This type of upgrade in name only is common to government IT projects at all levels of government, it essentially creates a more user friendly layer over the top of a patchwork of legacy systems and new off-the-shelf features. The VA and DoD maintain hundreds of data centers and legacy systems of various capabilities – an ineffecient IT infrastructure that the GAO says is unlikely to see real integration any time soon. Systems integrators like Harris and Accenture, have stepped into to offer more connectivity between these systems, although the long-term viability of this approach is an open question.

On the vendor side, upstarts are also capitalizing on the influx of capital happening in health IT to stake out sweeping patents, barrowing from the BigIT playbook for eliminating competition. As CivSource has reported, MMR Global could be considered one such company. Spending in electronic health records is expected to jump 76% by 2015, a brief we mentioned from the National Coordinator for Health Information Technology, released last year shows that states are already showing double digit increases in their use of electronic health records. Highlights coming out of the HIMSS Conference this week should provide a good look at who the main players over the near term will be.