Online access spurs greater use of healthcare services

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Patients with online access to their medical records and email communication with clinicians have more interaction with their clinicians, including office visits and phone calls, according to a study published this week in the Journal of the American Medical Association.

The results contradict previous research suggesting that if patients could look up test results, schedule appointments and request refills themselves, they would use traditional healthcare services less.

Researchers at Kaiser Permanente Colorado compared the use of clinical services before and after an online system called My Health Manager was implemented for both 44,321 users of the system and an equal number of non-users.

Among users of the system, they found a significant increase in office visits (0.7 per member per year) and telephone encounters (0.3 per member per year), as well as a rise in after-hours clinic visits (18.7 per 1,000 members per year), emergency department encounters (11.2 per 1,000 members per year), and hospitalizations (19.9 per 1,000 members per year). The pattern held true for members younger than 50, as well as those over 50.

Lead researcher Ted Palen estimated for a physician practice of 1,000 patients, the increase would amount to 10 more office visits a week, Reuters reports.

The researchers said there are several possible explanations for the results, including that more health concerns arose through online access, and that members who already were likely to use such services sign up for the online service to increase their access.

The study's authors added that healthcare organizations should consider how to allocate resources to deal with the increased use of services.

"Our findings suggest that the relationship between online access and utilization is more complex than the simple substitution of online for in-person care suggested by earlier studies," the researchers wrote.

Getting patients to use online access remains a huge challenge for many providers in their quest to meet Meaningful Use requirements. A study published recently in the Journal of Medical Internet Research found that the perceived value of online access is key to the adoption of personal health records, a factor that could tie into those patients' increased use of clinical services. A previous Kaiser Permanente study also found a link between PHR use and patient loyalty.

To learn more:
- read the JAMA article
- here's the Reuters story

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