Majority of Veterans Interested in Sharing Personal Health Record Information with Caregivers and non-VA Healthcare Providers

BACKGROUND:
Electronic personal health records (PHRs) are increasingly available as tools to better inform individuals about their health and actively engage patients in their healthcare. A potential benefit of the PHR – one that has yet to be fully realized by most systems – is the opportunity to enhance communication among the network of individuals who care for patients. Patients frequently receive care from multiple healthcare providers, and many with chronic conditions also receive care from family members and/or friends. While shared PHRs could improve communication among patients, their caregivers, and their dispersed healthcare team, few PHRs offer this feature. This study explored patient preferences regarding shared access to electronic health information by surveying 18,471 individuals who used VA’s personal health record – My HealtheVet – between 7/7/10 and 10/4/10. My HealtheVet was designed to complement traditional clinical services and to empower patients and their families to play more active roles in their healthcare. Currently, My HealtheVet is linked to only some portions of Veterans’ medical records (e.g., medication lists, lab records), but VA is in the process of expanding these linkages, and Veterans can now use My HealtheVet to communicate with their primary care providers via Secure Messaging.

FINDINGS:

• A majority (79%) of My HealtheVet users were interested in sharing access to their PHR with someone outside the VA healthcare system: 62% with a spouse/partner, 23% with a child, 15% with another family member, and 25% with a non-VA healthcare provider.
• Preferences regarding degree of access varied based on the type of information being shared, the type of activity being performed, and the respondent’s relationship with the person. For example, My HealtheVet users were more likely to express interest in delegating certain activities, such as communication with care providers and entering health information, to an unrelated caregiver (73% and 80%, respectively) than to a spouse or partner (65% and 74%, respectively).
• Interest in sharing access to My HealtheVet was modestly, but significantly, greater among older Veterans and men, but did not vary by health status.

IMPACT:

• These findings are being used to inform the development and prioritization of requirements for My HealtheVet account delegation and enhancements for Secure Messaging and the VA Blue Button.

LIMITATIONS:

• The survey completion rate was 41%, therefore results may not be generalizable to all My HealtheVet users.

AUTHOR/FUNDING INFORMATION:
This study was partly funded through VA. Dr. Zulman is an investigator at HSR&D’s Center for Health Care Evaluation, Palo Alto, CA.