November 5, 2015

Many Americans lack access to or awareness of digital health tools, such as text appointment reminders and patient portals that can increase communication with their healthcare providers, according to a survey by The Council of Accountable Physician Practices (CAPP) and Bipartisan Policy Center (BPC). The survey also found most physicians don’t recommend using these digital tools, according to the consumer respondents.

For the survey, titled “Better Together: High Tech and High Touch – Patient-Physician Relationships in the New Millennium,” Nielsen’s Strategic Health Perspective program polled 5,014 U.S. residents and 626 physicians.

Digital technologies can help overcome the barriers to accessing medical care, yet our survey shows that these tools are not available to most Americans,” Robert Pearl, M.D., chairman of the Council of Accountable Physician Practices and CEO of The Permanente Medical Group and the Mid-Atlantic Permanente Medical Group, said in a statement. “Healthcare providers must step up our adoption of these common-sense and available solutions if we are truly going to reform healthcare delivery.”

Just 29 percent receive electronic reminders for appointments, medication refills or suggested care and 14 percent report having the ability to check medications online. In addition, only 15 percent receive communication via online messaging platform and 9 percent get text reminders, and that digital interaction is growing very slowly, such as only 4 percent growth for email correspondence about patient health.

And, despite the known prevalence of only mobile phones in low-income households, very few of these households reported having access to text-based services from their healthcare provider. For households with less than $35,000 annual income, only 6 percent report having access to text appointment reminders and only 2 percent of those households and 2 percent of Americans on Medicaid have access to text reminders about taking medications or other health measurements.

“These findings emphasize how few patients and providers are actually using the technologies that we use in most other aspects of our daily lives,” Janet Marchibroda, director of health innovation at the Bipartisan Policy Center, said. “A lack of appropriate incentives as well as regulatory and legislative barriers have prevented many healthcare providers’ from implementing these technologies. Yet as healthcare organizations are increasingly responsible for improving the health of large populations, they must rely more on efficient, technology-driven patient-physician relationships to achieve performance goals. That means society must create incentives that facilitate adoption of these tools and technologies.”

And the survey found that few consumers have expanded access to medical care, with 13 percent having access to evening and weekend hours to communicate with their provider.

And this access contrasts with what Americans want as far as access to digital health tools, the survey found. For instance, while 28 percent report having access to a portal to log on and see health information, 34 percent of respondents said they’d like to have such access. And, while 9 percent report getting text appointment reminders, 28 percent would like to have that interaction. Fifteen percent of respondents said they receive email correspondence about their health, while 25 percent want the ability to do so.

The data also showed that consumers who don’t currently have access to their providers through electronic or digital communications are most interested in ready access and online interactions: 36 percent preferred traditional telephone-based medical advice, while 34 and 36 percent, respectively, expressed interest in one-way engagement such as online appointment scheduling and online portals to access test results.

And, even patients with a significant disease burden, such as heart disease and cancer, do not have better access, the survey found, as only 4 percent of cancer patients and 6 percent of heart disease patients had access to text reminders about taking medication. And, the survey found that interest in digital health tools among respondents with significant diseases was the same as for the general population.

And, with regard to low-income patients, 22 percent of those respondents and 32 percent of respondents on Medicaid are interested in receiving text appointment reminders.

The survey also found a high interest in online submissions of questions that could be answer by a medical professional (30 percent) and the ability to submit photos of a condition or symptom for a phone or email consultation (26 percent).

According to patients who responded to the survey, only 11 percent of healthcare providers recommend using email reminders, only 8 percent recommend text reminders and 5 percent advice patients to use a mobile app to track physical activity levels.

And the physicians who were polled cited low use of telemedicine, with only 9 percent using remote monitoring of vital signs and 6 percent conducting patient consultations and diagnosis via video conferencing.

The survey report concludes that physicians’ skepticism of telemedicine and infrequent use of technology are barriers to broader adoption, and digital tools could improve access, patient satisfaction and care coordination to help reduce healthcare costs.


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