November 17, 2010
Government’s Personal Health Record Project Meets With Limited Enthusiasm From Patients
Research: Adoption, non-adoption and abandonment of a personal electronic health record: Case study of HealthSpace
HealthSpace, the internet-accessible personal health organiser developed as part of the National Programme for IT in the National Health Service, was significantly less popular than anticipated, a research team from the University of London has found.
Instead of the predicted 5-10% of the population signing up, only 0.13% of those invited got as far as activating the full functionality of their personal health record, according to the study published on bmj.com today.
Professor Trisha Greenhalgh from Barts and the London School of Medicine and Dentistry led the team and was joined by researchers from University College London and Raft Consulting. They studied uptake of HealthSpace from its release in 2007 until mid-2010.
HealthSpace is an internet-accessible personal health record. Its features include the facility to enter and store health data such as blood pressure or weight; a calendar to store health appointments; email-style communication with the person's general practitioner; and the ability to access their summary care record (a centrally stored summary of key medical details drawn from a person's general practitioner record). HealthSpace is free but users must register for a basic account (online) or an advanced account (in person at a front office run by their local Primary Care Trust)
Early business plans anticipated that between 5 and 10% of the over-16 population would become HealthSpace users. It was also predicted that patients would access their summary care records and notify their GP of errors, thereby driving up data quality in NHS medical records. In fact, only 2,913 people (0.13% of those invited to open an advanced HealthSpace account) actually did so, and the research team did not find a single person who had accessed their summary care record.
Problems included a complex registration process, a "clunky" user interface (some aspects of which have been upgraded since the research was undertaken), the need to enter much of the data oneself, limited functionality which did not seem to match how people actually looked after their own health, and the low levels of knowledge about, or interest in, the product from healthcare staff.
The recent emergence of rival products from commercial IT companies including Microsoft's HealthVault (released in the UK in June 2010) and Google's GoogleHealth (released in 2008) have raised questions about the place of a standard-issue personal health organiser from the NHS.
On the Net: