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November 20th, 2012
04:53 PM ET
Online access associated with uptick in doctor visitsPatient online access to doctors and medical records was associated with increased use of almost all in-person and telephone medical services, according to a study published Tuesday in the Journal of the American Medical Association. Those services included doctor appointments, telephone consults, after-hours clinic visits, emergency room visits and hospitalizations. Dr. Ted Palen and his team looked at members of Kaiser Permanente Colorado, an integrated health system with more 500,000 members that includes an online patient portal known as MyHealthManager (MHM). Palen and his team are all affiliated with Kaiser Permanente Colorado. They set out to learn more about the use of electronic medical records and their association to the amount of health care services patients use when they have online access to their health care. The study hypothesis was that access to MyHealthManager would lead to a decrease in in-person health care services, a common theory posed by supporters of electronic medical records and shown in previous studies. "That was what was surprising to us," says Palen, a clinician researcher at Kaiser Permanente's Institute for Health Research and the study's lead author. "This association seemed to be true across all visits and true for older users and younger users." Palen and his team had a large cohort of 44,321 MyHealthManager users compared to 44,321 non-users. All the participants were at least 18 years old and were enrolled in Kaiser Permanente Colorado for at least two years between March 2005 and June 2010. Palen and his team matched the participants on their age, gender, and their diagnoses of at least one of four chronic conditions: congestive heart failure, coronary artery disease, diabetes and asthma. Online access to MyHealthManager was defined as members who had activated an MHM account, kept it active for at least one year, and used at least one feature on the site. The researchers did not gather data on which features the patients used. The findings raise questions about what's driving the association, particularly because the results contradict the common wisdom that online access to health records and doctors will ultimately lead to fewer in-person visits. "It puts the onus on us and a lot of other researchers to delve in to this further, to really peel away the layers of the onion to find out exactly what is going on and get a better understanding," Palen says. Understanding is key, because online access to health care and medical records isn't going away, he says. "The horse is out of the barn on this thing," he says. "Electronic personal health records are out there. People enjoy using them."
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
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I don't think you need to be a rocket scientist to figure this one out. Patient sees "abnormal" test result. Patient does not know how to interpret test result. Patient gets freaked out by test result. Patients ends up back in doctor's office. All the while, the "abnormal" test result was not significant.
I agree, my wife is a doctor and most people call about the interpretation of their test results because they looked it up on the internet and might be something wrong with them. Another big complaint is when she lists them as obese, they call and want it removed from their records.
I have Kaiser and I think it's because their modern healthcare system creates a distance between Patient, Doctor/Provider, and Staff. Everyone becomes too reliant on this online information, nothing beyond what is notated digitally is known about the situation. That entire 35 minute conversation you had explaining to a staff/nurse about your health? Well its notated in the 4 key words they put on your record, have fun spending another 35 minutes explaining the same thing next time. The answer it seems that all of their employees tend to have is "make another appointment." They constantly seem to be wanting to push the work and responsibility off to someone else. My wife and I are going through our 2nd pregancy, but first with Kaiser and we have definitely had 3x as many appointments as our first son. Separate appointments for her OB/GYN, Radiologist, Sonogram, Lab – sometimes in different locations. There is just something about their system which results in very impersonal and inefficient care – even with all of their online records.
I know having online access has made it easier for me personally to seek preventive care services such as scheduling appointment and emailing my doctor. I have not seen the entire study but if having online access means that I am better informed and able to go in and see my doctor vs. ending up at urgent care or worse, the emergency room, then I would prefer to have online capabilities and access to my health records vs. not. Isn't the other focus is to have patients seek preventive care so if that means more office visits or telephone visits vs. an ER visit, then that is a good thing. ER visits and hospitalization is where the cost drivers are. I like having access to my health information and being able to manage my care online. I schedule my appointments and email my doctor online. I hear from family and friends about the many instances in which they have not needed to head into or call the doctor's office by having online capabilities. The initial uptick in visits may also translate that there are more people who getting involved and managing their care.
There seems to be something missing between provider sites, product & technology sites, and online support groups. Modern Health Talk (www.mHealthTalk.com) attempts to fulfill that role, connecting health consumers with tech solutions that help them stay safely and healthy at home as they age.
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