Survey Illustrates Health Care's Digital Divide

Black Book's national panel poll of consumers aims to judge patient adoption and acceptance of technology, as well as measure those impacts on the health care industry. The survey, conducted from September through December 2016, asked consumers to evaluate the technology they were exposed to, know of or interacted with as an active patient in the last 12 months.

Fifty-seven percent of consumers with contact experience to hospital, physician, or ancillary provider's technology in 2016 report being skeptical of the overall benefits of HIT such as patient portals, mobile apps, and EHRs mainly because of recently reported data hacking and a perceived lack of privacy protection by providers. The national survey which included 12,090 adult consumers.  

Key findings include the following:

Fear of Breaches Depresses Health Data Sharing
As the amount of available health data increases so does the hesitancy for consumers to share that information due to industry privacy and security issues.

The unwillingness of patients to comprehensively divulge all their medical information rose to 87% in Q4 2016. 

Fewer consumers at this point in time do not want their digital health histories to extend beyond their physician and hospital, previously measured in 2013 at 66% who were willing to divulge all personal health data to achieve enhanced care. Especially alarming to respondents were the concerns that their pharmacy prescriptions (90%), mental health notes (99%) and chronic condition (81%) data is being shared beyond their chosen provider and payer to retailers, employers, and or the government without their acknowledgment.

In a follow up to an Office of the National Coordinator (ONC) survey, Black Book found this year that 70% of American distrust health technology, sharply climbing from only 10% in 2014.  

Eighty-nine percent of consumers with 2016 provider visits report withholding health information during visits. Ninety-three percent responding expressed concerns over the security of their personal financial information, as high deductible Obamacare plans and co-pays have more banking and credit card data passing from providers.

Sixty-nine percent of patients confirm their belief that their current primary care physician does not demonstrate enough technology prowess for them to trust divulging all their personal information.

Partial Patient Records Degrade the Reliability of Analytics
Patients are becoming more demanding of information, clinical alternatives, and improved outcomes at the same time where pressure is on government and providers to reduce costs. Until the payment model moves to truly pay for value, some of the very innovative and effective health technology solutions may continue to be a hard sell to hospitals and physicians, according to survey results.

"Incomplete medical histories and undisclosed conditions, treatment, or medications raises obvious concerns on the reliability and usefulness of patient health data in application of risk based analytics, care plans, modeling, payment reforms, and population health programming," says Black Book's Managing Partner Doug Brown. "This revelation should force cybersecurity solutions to the top of the technology priorities in 2017 to achieve tangible trust in Big Data dependability."

Conversely, survey respondents related that more technology the physician is perceived as using to manage the patient's health care, the higher the trust level patients had in their provider. Eighty-four percent of patients said their trust in their provider is influenced by how the provider uses the technology, rather than only 5% of consumers had any issue in trusting in the actual technology.

Overworked Hospital Nurses Get Another Duty
Patients discharged from hospitals under 200 beds report being the most challenged by the patient portals, engagement tools, and monitoring systems provided. Ninety-two percent of patients express difficulty understanding the instructions or use of the technological applications.

Hospitals over 300 beds have the most success with patient technology satisfaction and usability.

"We can likely attribute this to the role of patient technological education falls on discharge nurses in large facilities," Brown says. The responsibility of mediating between patients and technology usually falls on nurses because they have the appropriate culture and clinical background to recognize actual patient needs and computer mastery." 

Ninety-two percent of nurse leaders in hospitals under 200 beds related there is no staffing time factored into the discharge process to improve patient tech literacy as compared to 55% of large hospitals which include patient portal orientations at discharge.

Physicians Don't Want All That Information
Ninety-four percent of physicians responding to the provider section of the survey find all that data overwhelming, redundant, and unlikely to make a clinical difference.

In contrast, 91% consumers with wearables believe their physician practice's medical record system should store any health related data they request.

Ninety-six percent of physician office patients said they left their visit with poorly communicated or miscommunicated instructions on patient portal use.

Ninety-four percent with health or activity trackers said their physician, when asked, informed them the practice had no capability or interest in coordinating their outcomes currently via their EHR. Ninety-eight percent of patients using a nutritional or weight loss app had similar responses from their doctors.

Conversely, 82% of physicians surveyed report that some highly literate patients surfing health care internet sites collect both valid and invalid information about their condition, often complicating diagnoses and exceeding time allotments for visits currently under the current system.

Four in 10 patients attempted to use the portal provided by their physician, but 83% found it difficult to navigate when at home.

Eighty-five percent of doctors lamented that the addition of EHRs and other technologies has made patient care too impersonal. Yet a larger disengage between doctors and patients is occurring, noted by the  89% of consumers surveyed demanding access to more information and choices in their treatment providers, locations, and alternatives.

"In this age of health care consumerism people want to receive care through technologically enabled alternatives like telemedicine visits, secure e-mail communications with their practitioner, and immediate access to records and scheduling," Brown says.

Ninety-one percent of patients who find their apps and devices relevant to their health improvement felt slighted by their providers who would not accommodate their personal data.

Patient Technology Illiteracy Is the Next Road Block to Achieving Population Health Success
Patients who have higher health literacy rates are also the most skeptical about sharing data because of the lack of cyber security measures, particularly among medical groups, clinics, and ancillary facilities according to survey results.

Ninety-four percent of providers recommend government funded programs to afford and enhance health technology literacy training to patients.

"With so many consumers skeptical of the benefits and security of HIT, the software developers must address a wider targeted patient population as we move forward in modeling, analytics, and accountable care," Brown says.

Source: Black Book