Silver surfers seeking digital options for healthcare information

Accenture has released the results of a global survey of older people and their attitudes towards digital healthcare technology, finding that while older Australians would like to use technology such as electronic reminders and online prescription refill requests, they rate the importance of such online services lower than consumers in other surveyed countries.

The survey is part of ongoing analysis of research that has also recently surveyed doctors' attitudes towards allowing patients access to electronic medical records and consumer attitudes to the same.

The consumer research involved over 9000 people in nine countries, including Australia, Brazil, Canada, England, France, Germany, Singapore, Spain and the US, of which 1000 were aged over 65, 175 of them Australian.

Of those older people, 63 per cent are seeking digital options for managing their health, the survey found. Although roughly three-quarters (77 per cent) of seniors surveyed say that online access to their health records is important, only 17 per cent say they can currently access them.

The survey found that Australian seniors predominantly wanted access to healthcare technology such as electronic reminders (68 per cent) and online prescription refill requests (55 per cent), but that only 18 per cent of healthcare providers currently offer such capabilities.

Similarly, half of respondents want to be able to email healthcare providers, but only six per cent say they currently have that capability.

Leigh Donoghue, managing director of Accenture’s health business in Australia, said that older Australians are increasingly online and digital tools were giving them more options to remain connected and manage many areas of their lives from home, including virtual healthcare services.

“Healthcare providers must expand their digital options if they want to help their senior patients more actively participate in their own care,” Mr Donoghue said. “As the sector moves into an era of consumer-directed care, digital tools can enable service providers to better meet the needs and requirements of senior citizens.”

While the Accenture survey found that the majority of Australian seniors (62 per cent) do not actively track aspects of their health, such as health indicators, health history and physical activity, he expected the general market for connected and standalone health devices, applications and services to continue to grow rapidly.

“Seniors are already a part of this, being notable users of health devices such as blood pressure and heart-rate monitors,” he said.

“Given the health needs and motivation of this group and the accumulated wealth of the baby boomer generation, it’s likely to be a priority growth segment for many product and service providers. This will accelerate as more seniors move online.”

The survey found that Australian seniors rated the level of importance of such online services much lower than older consumers in other surveyed countries. The majority of seniors in Spain, for example, where electronic medical record adoption is much higher, want access to online prescription refill requests (79 per cent), online access to medical information (91 per cent), and online appointment booking functionality (87 per cent).

In Australia, we tend to be a bit more conservative in this respect, from both a patient and doctor perspective, but that is likely to change, Mr Donoghue said.

“There is a lot of conservatism in the health sector: we’re creatures of habit when it comes to patient care. This is a barrier to consumer take-up of new applications and services, particularly where seniors are concerned since they have a traditional deference to clinicians (‘doctor knows best’).

“This will change and is changing as more enlightened healthcare providers refocus on creating a better patient experience – electronic repeats are a part of this – and demand more from their vendors to support this.

“It’s also happening as vendors look for new ways to differentiate and respond to the patient-centred care agenda: look at how EMIS, the leading GP vendor in the UK, has created Patient Access and promoted this among GP practices."

Most importantly, however, increased demand for digital healthcare services is going to be driven through consumers and consumer groups, he said, with “networks of older people going online with the time and inclination to swap stories, apps and experiences".

The proportion of American seniors active online recently passed 50 per cent and is now the fastest growing segment. Mr Donoghue said this makes it an increasingly attractive market for online services in the US, helping spawn new health products and services.

“Australia’s behind on this curve but it won’t be long. GPs and pharmacists will have to respond to this: if they don’t they risk being bypassed.”

Mr Donoghue said the level of awareness of the privacy and financial implications of more digital access to healthcare services and healthcare providers is "mixed" in Australia, but that consumers can surprise by how much information they're willing to share online.

The financial ramifications are equally challenging in a predominantly public health system like Australia’s, he said.

“Online access could significantly increase demand for services and the number of care episodes, further compounding the affordability challenge. It may be possible to partially offset this through co-payments: asking patients who can afford to pay to contribute for a different level of service. However, this risks exacerbating the digital divide for lower income patients."

He said new payment and governance structures will be required to provide consumers with access to digital services where appropriate, but that conversely, other online transactions have the potential to save money for healthcare providers. There is a positive financial implication for online scheduling or online assessments.

"It will be interesting to see whether healthcare providers are willing share any of these savings with consumers to increase adoption.”

Mr Donoghue said that while there was still a 'doctor knows best' element, as the proportion of older people increases along with levels of chronic illness, consumers will begin to demand more access to the healthcare information held on them by providers.

“Chronically ill patients are more likely to record their health and keep a record, if only to improve the continuity of care they receive as they traverse the health system and deal with multiple care providers."

It will be consumer demand, allied to an increase in services offered by health insurers and some government intervention, that will drive the electronic sharing of information by healthcare professionals, he said.

“Government interventions typically achieve only so much, particularly in terms of compelling clinicians to share patient information. This touches upon the thorny issue of who actually owns the patient record, and the rights and obligations associated with this.

“As authors, many healthcare professionals feel a strong sense of ownership for the record and a reluctance to share this information with other clinicians and sometimes even patients. This remains a highly contentious issue in Australia, and one that governments are understandably cautious about.”

He points to the UK, which has experienced the same debate over the past decade. There, direct government interventions included funding centrally hosted systems to support sharing through programs such as the National Programme for IT, mandating patient rights as part of the NHS constitution and engaging the royal colleges and the British Medical Association to develop a charter in terms of shared record use.

“This has shifted the debate, with a consensus increasingly emerging around the electronic sharing of information,” Mr Donoghue said. “Consumer demand has been a factor in this, but more as an adjunct to public policy rather than the primary driver.

“It’s unlikely that such an approach could be replicated in Australia for a range of reasons. Here, consumer demand is likely to play a more significant role in driving the electronic sharing of information, combined with public and private health management organisations, particularly health insurers, promoting new models of care, and the increasing impact of disruptive technologies. Government interventions are likely to be crucial in enabling this.”

Posted in Aged Care

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