Personal Health Record Use in the United States: Forecasting Future Adoption Levels

Background: Personal health records (PHRs) offer a tremendous opportunity to generate consumer support in pursing the triple aim of reducing costs, increasing access, and improving care quality. Moreover, surveys in the United States indicate that consumers want Web-based access to their medical records. However, concerns that consumers' low health information literacy levels and physicians' resistance to sharing notes will limit PHRs' utility to a relatively small portion of the population have reduced both the product innovation and policy imperatives. Objective: The purpose of our study was 3-fold: first, to report on US consumers' current level of PHR activity; second, to describe the roles of imitation and innovation influence factors in determining PHR adoption rates; and third, to forecast future PHR diffusion uptake among US consumers under 3 scenarios. Methods: We used secondary data from the Health Information National Trends Survey (HINTS) of US citizens for the survey years 2008, 2011, and 2013. Applying technology diffusion theory and Bass modeling, we evaluated 3 future PHR adoption scenarios by varying the introduction dates. Results: All models displayed the characteristic diffusion S-curve indicating that the PHR technology is likely to achieve significant market penetration ahead of meaningful use goals. The best-performing model indicates that PHR adoption will exceed 75% by 2020. Therefore, the meaningful use program targets for PHR adoption are below the rates likely to occur without an intervention. Conclusions: The promise of improved care quality and cost savings through better consumer engagement prompted the US Institute of Medicine to call for universal PHR adoption in 1999. The PHR products available as of 2014 are likely to meet and exceed meaningful use stage 3 targets before 2020 without any incentive. Therefore, more ambitious uptake and functionality availability should be incorporated into future goals.