David Cerino, general manager for consumer health solutions at Microsoft (Redmond, Washington), dealt with consumer attitudes at yesterday's session at the World Health Care Congress, asserting that "we have to get consumer engagement" in order to make HIT work. Just as e-banking sparked fears in the first couple of years, "you might see privacy and security [concerns] go up" as electronic health records (EHRs) become more commonplace.

However, Cerino also said he sees a health gatekeeper in the home that software vendors ought to take into account when creating web-based HIT interfaces. He said that women between the ages of 28 and 54 routinely serve as "family health managers" and that their attitudes and the demands placed on their time can make or break the effort to bring the consumer along.

"The protector of this family doesn't have a lot of time" for clumsy systems and "will not sit behind their PC for hours" trying to deduce why the information is not coming through in a timely or intelligible fashion, Cerino said.

Consumer adoption might be slow at first, but it will happen if the software works, Cerino seemed to argue. "When you first started into online banking, it was painful" due to all the work involved in getting things set up, he said, but he reminded the audience that "once you did it, you never looked back" because users began to trust such systems.

"As an industry, we're a little too deep into detail," he said, explaining that "we're launching them into this level of detail that maybe they're not ready for." Vendors will have to make the information in an EHR "easier to understand," he said, stating further that "the way you show data has to be the way they expect it." Obviously jargon and industry-centric nomenclature are anathema. "They will get it" if the information is in terms patients/consumers understand.

"If we don't include the consumer, we strongly believe we've lost" any chance to maximize the value of a national HIT system, Cerino said. "You have to put that patient or consumer at dead center" of the matrix of important parties.

– Mark McCarty, Washington Editor