Impact Insights

Week in Review 12/19/14

When given the opportunity, almost half of patients (49%) decided to withhold information in their medical record from providers, according to a new study in the Journal of General Internal Medicine. As part of the six-month trial, the 105 participating patients were allowed to restrict providers from seeing certain data in the EHR (either all data like diagnoses, medications, test results, etc. or just sensitive data such as sexually transmitted infections and drug/alcohol abuse). If a provider felt a situation made it medically necessary to view the hidden data, they could hit a button to “break the glass” and access the full record. The authors found providers “infrequently” did so though; in fact, more than half of participating providers (54%) felt patients “should have control over who sees their EHR information.” However, 71% of participating providers also felt that allowing patients to restrict the information providers can access in the EHR would negatively impact quality of care.

Impact Advisors’ Thoughts: Granted, the study only involved 105 patients, but it underscores yet another barrier to effective health information exchange: patient willingness to have their data shared. With some HIE initiatives requiring patients to formally opt-in (and virtually all allowing anyone to opt-out), providing patients with education on the importance of sharing clinical information (even sensitive clinical information) with all members of their care team will be essential.


Hospital adoption of social media is “widespread,” according to a recent study in the Journal of Medical Internet ResearchResearchers looked up 3,371 U.S. hospitals and found that 99% had a Facebook account, 99% had a Foursquare account, 99% had a Yelp account, and 51% had a Twitter account. Overall, the study found that “utilization” (i.e. the number of Facebook “likes”, Twitter followers, Foursquare “check-ins,” and Yelp reviews) was higher among large, urban, private nonprofit, and teaching hospitals.

Impact Advisors’ Thoughts: Two thoughts:

  • The term “hospital adoption” is somewhat misleading in this study, since two of the platforms looked at – Foursquare and Yelp – are driven almost entirely by patient activity and reviews.
  • Although the authors found that virtually all hospitals have a Facebook page – and more than half have a Twitter account – that doesn’t necessarily mean social media is being used effectively by hospitals to change patient behavior or influence patient decisions. For example, the annual H&HN Most Wired study found that even among the “Most Wired” hospitals in the country, only 35% use social media to send care management messages.