Survey: Patients want revamped healthcare, EMRs

Seventy percent of adults think the U.S. healthcare system needs to be fundamentally changed or completely rebuilt. A large majority also want their care to include health IT such as EMRs and data exchange, according to a Commonwealth Fund survey.

The respondents' concerns reflect "widespread experiences with access barriers, poorly coordinated care and growing costs," wrote Kristof Stremikis, MPP, Cathy Schoen, MS, and Ashley-Kay Fryer in the survey titled "A Call for Change: The Commonwealth Fund 2011 Survey of Public Views of The U.S. Health System."

A large majority of U.S. adults have concerns about access, with 71 percent reporting problems gaining access to needed healthcare, according to the authors. Survey respondents cited the inability to get timely doctors’ appointments or advice from their physician on the phone, or to obtain after-hours care without going to the emergency room.

Forty-seven percent said they experienced poorly coordinated care while 54 percent reported wasteful care. In addition, one in five respondents reported they or a family member ended up with an infection or complication as a result of medical care, or said that a healthcare provider made a surgical or medical mistake.

When asked about the future, 74 percent of those surveyed stated they are worried they won’t get high-quality care when they need it, or that they won’t be able to afford their medical bills if they become seriously ill.

In addition, 85 percent of respondents support policies that would improve care coordination and would provide more transparent information about healthcare costs and quality. There was strong support for medical homes and a team approach to care, with 93 percent of people saying it was important or very important to have one place or doctor responsible for primary care and for coordinating additional care. Eighty-six percent of those surveyed support doctors and nurses working in teams or groups with an expanded role for nurses.

A large majority of respondents also want their doctors to use health IT: 88 percent thought it was important or very important for doctors to use EMRs, and 92 percent thought it was important or very important for doctors to be able to share information electronically with other doctors.

Survey respondents also want to use technology to manage their own healthcare—currently, only 14 percent of adults with internet access reported that they can access their medical records online and just one in five can schedule appointments electronically or email their doctors. Of those who can’t do any of those things, half said they would like to have electronic access to records and more than half would like to schedule appointments online, and to be able to email their doctors.

"Addressing the public’s concerns about costs and worries about the future will likely require intensified efforts that focus on prices paid by private and public payors and rising cost trends. The survey found strong public support for allowing private and public payers to work together to negotiate prices and improve quality," the authors concluded. “Based on the survey, a majority of the public would endorse a more concerted effort by payers to act in the broad public interest to slow cost growth and to focus on quality and access."

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