Study finds no impact on high blood pressure in patients using personal health records.
By definition a personal health record (PHR) is a useful tool whereby patients maintain an accurate, online summary of their medical history. The health data on a PHR might include patient-reported outcome statistics, lab results, or figures from devices such as wireless electronic weighing scales or collected passively from a smartphone. Nevertheless, PHRs have been slow on the uptake with only 10 percent of the public using them. The biggest barrier being privacy issues ― fear of personal information being accessed by computer hackers; and access limitations.
A group of U.S. researchers set out to examine the impact of a PHR in patients with hypertension measured by changes in biological outcomes, patient empowerment, patient perception of quality of care, and use of medical services.
For the study, published in the Journal of the American Medical Informatics Association, they compared patients from two ambulatory clinics – 194 received a PHR and 252 received care as usual without a PHR. A PHR attached to the patient’s electronic medical record (EMR – records operated by institutions, such as hospitals withy data entered by clinicians or billing data) was the primary intervention and included security measures, patient control of access, limited transmission of EMR data, blood pressure tracking ability, and appointment assistance. Blood pressure was the main outcome measure.
Results showed no impact of the PHR on hypertension, patient activation, patient perceived quality, or medical utilization in the intention-to-treat analysis. Sub-analysis of intervention patients self-identified as active PHR users (25.7 percent of those with available information) showed a 5.25-point reduction in diastolic blood pressure. Younger age, self-reported computer skills, and more positive provider communication ratings were associated with frequency of PHR use.
They concluded that few patients provided with a PHR actually used it with any frequency. Thus simply providing a PHR may have limited impact on patient blood pressure, empowerment, satisfaction with care, or use of health services. In short, adoption of PHRs will require more education and provider intervention in order for them to have any significant impact on clinical outcomes.