Demographic characteristics of Australian health consumers who were early registrants for opt-in personally controlled electronic health records

Abstract

Background:

Differential uptake of, or access to, personal electronic health records (PEHRs) has the potential to impact on health disparities among certain social groups. In 2012, the Australian Government introduced the Personally Controlled Electronic Health Record (PCEHR), an opt-in system operated by the then National E-Health Transition Authority (NEHTA). In July 2016, the My Health Record (MyHR), an opt-out model, operated by the Australian Digital Health Agency replaced the PCEHR, providing additional support for consumers.

Objective:

This research was carried out between 2012 and 2015, covering the opt-in PCEHR phase. The aim of the study was to explore demographic characteristics of Australian health consumers who were first to register for a PEHR, and to identify the age and gender populations less likely to register for a PEHR in the opt-in format. The study aimed to provide early data on registrants and potential methods to encourage individuals to register for a PEHR.

Method:

A cross-sectional study investigated differences in registrations for PEHRs from 2012 to 2015 by age and sex.

Results:

Results revealed that males were less likely to register than females, and adolescents of both sexes were the least likely to register when compared with any other age group. Similarly, middle-aged males had among the lowest reported registrations, as did older females.

Conclusion:

While e-health has the potential to improve health outcomes and PEHRs the potential to empower consumers to better manage their health and improve their access health services, evidence from this study suggested that some population groups that experience health inequalities (e.g. older people) were underrepresented among registrants for PEHRs. As income, ethnicity and education are major drivers for health disparities in Australia, future research should focus on uptake and use of PEHRs (now the MyHR) from the perspective of these variables.

Keywords

personal health records electronic health records electronic medical records personal health information health information management My Health Record MHR MyHR Personally Controlled Electronic Health Record PCEHR

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References

Andreassen

Bujnowska-Fedak

Chronaki

. (2007) European citizens’ use of e-health services: a study of seven countries. BMC Public Health 7(1): 53–53.

Australian Bureau of Statistics (ABS) (2008) Risk Taking by Young People. Australian Social Trends, 2008, cat. no. 4102.0, ABS. Available at: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Chapter5002008 (accessed 29 September 2016).

Australian Bureau of Statistics (ABS) (2010) Health and Socioeconomic Disadvantage. Australian Social Trends, 2010, cat. no. 4102.0, ABS. Available at: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features30Mar+2010 (accessed 27 September 2016).

Australian Bureau of Statistics (ABS) (2011) Health Services: Use and Patient Experience. Australian Social Trends, 2011, cat. no. 4102.0, ABS. Available at: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features20Mar+2011 (accessed 27 September 2016).

Australian Bureau of Statistics (ABS) (2012) Australian Health Survey: Health Service Usage and Health Related Actions, 2011–2012, cat. no. 4364.0.55.002, ABS. Available at: http://www.abs.gov.au/ausstats/Subscriber.nsf/LookupAttach/4364.0.55.002Data+Cubes-26.03.131/$File/43640DO001_20112012.xls (accessed 27 September 2016).

Australian Bureau of Statistics (ABS) (2014) Deaths, Australia, 2013, cat. no. 3302.0, ABS. Available at: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3302.02013?OpenDocument (accessed 27 September 2016).

Australian Digital Health Agency (2017) My Health Record Statistics. Available at: https://myhealthrecord.gov.au/internet/mhr/publishing.nsf/content/mhr-statistics (accessed 20 April 2017).

Australian Government Department of Health (2013) Review of the personally controlled electronic health record, Department of Health. Available at: http://health.gov.au/internet/main/publishing.nsf/Content/46FEA5D1ED0660F2CA257CE40017FF7B/$File/FINAL-Review-of-PCEHR-December-2013.pdf (accessed 30 May 2016).

Australian Government Department of Health (2015) Parents and their babies, Department of Health. Available at: http://www.ehealth.gov.au/internet/ehealth/publishing.nsf/Content/brochure-families (accessed 30 May 2016).

10.

Australian Institute of Health and Welfare (AIHW) (2012) Australian Hospital Statistics 2011–2012: Emergency Department Care. Health Services Series no. 45, AIHW. Available at: https://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CB0QFjAA&url=http%3A%2F%2Fwww.aihw.gov.au%2Fworkarea%2Fdownloadasset.aspx%3Fid%3D10737423039&ei=LsJWVe68NIOwmAWV6IEw&usg=AFQjCNFg5w4sjBF81YbjKYZ0_3DRYz0cXA&bvm=bv.93564037,d.dGY (accessed 6 October 2016).

11.

De Lusignan

Seroussi

(2013) A comparison of English and French approaches to providing patients’ access to summary care records: scope, consent, cost. In: Blobel

Hasman

Zvavova

(Eds) Data and Knowledge for Medical Decision Support. Amsterdam: IOS Press, pp. 61–65.

12.

Dixon

Correa

Straubhaar

. (2014) Gendered space: the digital divide between male and female users in Internet public access sites. Journal of Computer-Mediated Communication 19(4): 991–1009.

13.

Djamasbi

Wilson

(2015) The relationship of demographics to consumers’ use of an extended range of e-health services. Paper presented at the 48th Hawaii International Conference on System Sciences, Kauai, 5–8 January 2015. Available at: http://digitalcommons.wpi.edu/cgi/viewcontent.cgi?article=1047&context=uxdmrl-pubs (accessed 10 Mach 2015).

14.

Evans

(2011, 11 24) PCEHR And The ‘Opt-In’ Model - Are We Swimming Against The Tide? Pulse +IT. Retrieved from http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=781:pcehr-and-the-opt-in-model-are-we-swimming-against-the-tide&catid=16:australian-ehealth&Itemid=328.

15.

Fox

Duggan

(2013) Health Online 2013 Pew Research Centre’s Internet & American Life Project (pp. 1–55). Washington: Pew Research Centre. Retrieved from http://www.pewinternet.org/2013/01/15/health-online-2013/

16.

Galdas

Cheater

Marshall

(2005) Men and health help-seeking behavior: literature review. Journal of Advanced Nursing 49(6): 616–623.

17.

Goel

Brown

Williams

. (2011) Disparities in enrollment and use of an electronic patient portal. Journal of General Internal Medicine 26(10): 1112–1116.

18.

Greenhalgh

Hinder

Stramer

Bratan

Russell

(2010) Adoption, non-adoption, and abandonment of a personal electronic health record: case study of HealthSpace. British Medical Journal, 341(7782), 1091–1091.

19.

Heart

Kalderon

(2013) Older adults: are they ready to adopt health-related ICT? International Journal of Medical Informatics, 82(11), e209–e231.

20.

Higgins

Sixsmith

Barry

Domegan

(2011) A Literature Review on Health-Information Seeking Behavior on the Web: A Health Consumer and Health Professional Perspective. Retrieved from http://ecdc.europa.eu/en/publications/Publications/Literature%20review%20on%20health%20information-seeking%20behaviour%20on%20the%20web.pdf

21.

Lemire

Pare

Sicotte

. (2008) Determinants of Internet use as a preferred source of information on personal health. International Journal of Medical Informatics 77(11): 723–734.

22.

Kontos

Blake

Chou

WYS

Prestin

(2014) Predictors of eHealth usage: insights on the digital divide from the Health Information National Trends Survey 2012. Journal of Medical Internet Research, 16(7), e172. doi: 10.2196/jmir.3117

23.

Lustria

MLA

Smith

Hinnant

(2011) Exploring digital divides: An examination of eHealth technology use in health information seeking, communication and personal health information management in the USA. Health Informatics Journal, 17(3), 224–243.

24.

National E-Health Transition Authority (NEHTA) (2013) PCEHR Score Card, NEHTA. Available at: http://www.nehta.gov.au/component/docman/doc_download/1777-nehta-scorecard-august-2013?Itemid= (accessed 29 November 2016).

25.

National E-Health Transition Authority (NEHTA) (2015) PCEHR, NEHTA. Available at: http://www.nehta.gov.au/our-work/pcehr (accessed 29 November 2016).

26.

Nolke

Mensing

Kramer

. (2015) Sociodemographic and health-(care-)related characteristics of online health information seekers: a cross-sectional German study. BMC Public Health 15: 31.

27.

CKL

Karsh

B-T

(2009) A systematic review of patient acceptance of consumer health information technology. Journal of the American Medical Informatics Association 16(4): 550–560.

28.

Ramon-Jeronimo

Peral-Peral

Arenas-Gaitan

(2013) Elderly persons and internet use. Social Science Computer Review, 31(4), 389–403.

29.

Roblin

Houston

Allison

. (2009) Disparities in use of a personal health record in a managed care organization. Journal of the American Medical Informatics Association 16(5): 683–689.

30.

Ronda

MCM

Dijkhorst-Oei

Gorter

. (2013) Differences between diabetes patients who are interested or not in the use of a patient web portal. Diabetes Technology & Therapeutics 15(7): 556–563.

31.

Sarkar

Karter

Liu

. (2011) Social disparities in Internet patient portal use in diabetes: evidence that the digital divide extends beyond access. Journal of the American Medical Informatics Association 18(3): 318–321.

32.

Sue

Griffin

Allen

(2011) Individual characteristics associated with PHR use in an integrated care organization. Paper presented at the Proceedings of the 44th Hawaii International Conference on System Sciences, Kauai, 4–7 January 2011. Available at: http://ieeexplore.ieee.org.ezp01.library.qut.edu.au/stamp/stamp.jsp?tp=&arnumber=5718547 (accessed 10 October 2016).

33.

Wakefield

Kruse

Wakefield

. (2012) Consistency of patient preferences about a secure internet-based patient communications portal. American Journal of Medical Quality 27(6): 494–502.

34.

Wilson

Balkan

Lankton

(2014) Trends in US consumers’ use of e-health services: fine-grained results from a longitudinal, demographic survey. Communications of the Association for Information Systems 34(1): 73.