Thursday, April 23, 2009

HIMSS 2009 - How Consumers use PHRs (KP)

While at HIMSS 2009 in Chicago early this month I did attend a very interesting talk from Judy Derman and Jan Oldenburg from Kaiser Permanente untitled: "How Consumers use Personal Health Records (PHRs) : lessons learned".

Kaiser Permanente (KP) has a very large user based (2.5M consumers/patients and 13,000 healthcare professionels) for their online services (a portal accessible at portal and My Health Manager, a Personal Health Record (PHR) built with the help of EPIC).

In this talk, Judy and Jan described the lessons learned from usage patterns on these web applications.

The consumers/patients are motivated by the fact that they can act on their information. It is not just about looking at a medical record, but act one it. Example of useful actions include:
  • start changing health related behavior
  • refill a prescription online
  • make appointment with their doctor
  • send email with care professionals
  • access educational programs (some of the most popular are: diabetes, depression, insomnia, weight management)
The consumers will trust these applications and the associated medical information as long as it is :
  • transparent
  • accessible
  • consistent
  • secure
  • timely and accurate
Kaiser Permanente study shows that the implementation success factors include:
  • early adopters are leaders in usage and feedback
  • there is a strong leadership from senior leaders
  • importance of clearly define explicit and articulated benefits
  • allocate appropriate and sufficient resources to do the job
  • resource must have appropriate skills
  • involve stakeholders / members / patients early in the process
  • make decision at the appropriate level
  • provide tools to support implementation (marketing material and toolkits)
  • use standard prcedures
  • use effective and integrated marketing
  • simplify the "getting started" mechanism (one step activation + pre-populate heath record)
  • drive adoption with multiple channel marketing
The Kaiser PHR was launched in January 2007 and has reached 2.7 users by April 2009.

In 2008, 84% of the users choose the "One step activation" mechanism and 54% of KP members signed-in with 40.8% of user male and 51.2% female.

Here are the top features in the last two years:

Here are some statistics/facts about the Email/secure messaging service of the KP PHR:
  • 6M emails in 2008 sent to doctors (13M since the launch in 2007)
  • 600,000 emails per months in 2009
  • 14% of messages are written by physicians and clinicians
  • 14,000 physicians are using emails regularly
One of the benefits of the email services is that the patients using email were 7-10% less likely to schedule an appointment.

Here are some statistics/facts about the Lab/test results service of the KP PHR:
  • 16.7M test in 2008
  • 61M tests results available online
  • 31M since launch
  • certain tests are not online (HIV, genetic tests ...)
Here are some statistics/facts about the Presciption refill service of the KP PHR:
  • 5.6M refill in 2008
  • increase of 26% in 2007-2008
  • Up to 23% of refill are done online