This paper, published in this month’s The Journal of Pediatrics (not to be confused with the journal named Pediatrics), demonstrates that personal health records are not about replacing in person visits, sometimes they increase them, for better health.
Researchers at Kaiser Permanente Hawaii (@KPHawaii) and Kaiser Permanente Northwest (@KPNorthwest) compared populations of parents who did and did not access their child’s medical records online from birth to age 2, and whether or not their children were more likely to have received the correct number of well-child visits and immunizations. In this study, then, more is better.
The comparison of the two regions is interesting because Hawaii, which has had online services for less time than Northwest, has among the lowest adoption rates of the kp.og personal health record in the Kiaser Permanante system, which is still an-unheard-of-in-health-care 53%. In the Northwest region, which pioneered the use of online services for Kaiser Permanente, it’s a-really-unheard-of-in-health-care 67%.
In Hawaii, there was not a significant difference in completion of immunizations at 2 years between families who did and did not access the personal health record. In the Northwest, there was about a 20% higher likelihood that a child whose parent accessed the online medical record did.
For well child care, in both regions there was a significant association with PHR use and having had 6 or more well child visits, between 30%-300% between the two regions.
It’s worth noting that as currently configured, the kp.org personal health record does not prompt parents for well-child care (yet), although it does provide access to completed immunizations and appointment history, so this study is just looking at parents engaging in their child’s care online. As I’ve discussed here previously, both regions have exquisitely accurate population care systems in the care setting that do have this information and prompt families and clinicians together (see: Now Reading: Health Information Technology can Improve the Care of Populations (going to Portland to see how it does) | Ted Eytan, MD).
As the authors state, this is one of the first studies looking at the use of personal health records in well child care. It shows that the outcome of interest for PHRs is improved health, not more or less visits.