Online Health Info Access Linked to Clinical Services Use

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Researchers with Kaiser Permanente in Denver, Colorado found health plan members with access to their medical records and the ability to communicate online with clinicians made more use of clinical services than members without online access. The findings of the team from Kaiser Permanente’s Institute of Health Research appear in the 21 November issue of the Journal of the American Medical Association.

The study led by Kaiser Permanente’s Ted Palen examined the health records of more than 500,000 members of Kaiser Permanente in Colorado between May 2005 and June 2010. The researchers looked at the rates of office visits, telephone encounters, after-hours clinic visits, emergency department encounters, and hospitalizations of members enrolled for at least 24 months, with access to the health care provider’s patient portal, called My Health Manager, compared to members who did not have access to the portal.

Kaiser Permanente says My Health Manager is linked to the provider’s electronic health record system, called HealthConnect. My Health Manager lets users see their health records, view lab test results, send e-mail to their physicians, request prescription refills, and manage their appointments for themselves and, if authorized, also for family members.

Specifically, Palen’s team matched more than 44,000 online users with 44,000 non-online users, and for the online group, tallied their use of clinical services before and after being granted access. The findings show members with My Health Manager had 16 percent more office visits and 8 percent more telephone calls per member per year, after signing up for online access, compared to their use of these services before they had online access. Members without access to My Health Manager, on the other hand, had 8 percent fewer clinic visits and no change in telephone calls per member per year over the course of the study.

The researchers found use of in-person clinical services, such as emergency visits and in-patient hospital stays, were higher for members with access to My Health Manager than those without online access. Members with asthma or diabetes and using My Health Manager had significantly increased rates of office visits, 15 percent and 13 percent respectively, compared to their pre-online access rates.

The study found an association between patients’ use of online tools and an increase in clinical services, but it did not determine or examine the reasons behind the increase. The authors speculate in the article that “Members might have activated their online access in anticipation of health needs. Members who are already more likely to use services may selectively sign up for online access and then use this technology to gain even more frequent access rather than view it as a substitute for contact with the health care system.”

Palen notes that Kaiser Permanente members have “become more mature in their understanding of and use of the online health care tools available to them through My Health Manager. Our future research will examine the impact of these tools on health care delivery models, patient health status, and their health outcomes.”

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