The Future of Oncology Care with Personal Health Records

2012 ◽  
pp. e66-e69 ◽  
Author(s):  
Henry Feldman ◽  
Elizabeth S. Rodriguez
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Clinical Information ◽  
Personal Health Records ◽  
Personal Health ◽  
Patient Portal ◽  
Care Providers ◽  
Health Records ◽  
Improve Patient

Overview: Personal health records (PHRs) and patients' access to their own clinical information through a patient portal are changing the patient-physician relationship. Historically, health care providers have been gatekeepers of patients' medical records. Now, these portals provide patients access to clinical information, electronic messaging with the clinical team, and appointment and billing information. This type of access supports patient empowerment by engaging patients in their own care. Patients desire online access to information. The health care industry, like any other, must respond to the needs of its consumers. Oncology practices face unique challenges to meeting this need because of the complex nature of medical records of patients with cancer. Health care providers worry about the consequences of patients receiving “bad news” online, thereby increasing patient anxiety. This anxiety may, in turn, increase providers' workload by creating additional calls or visits to the office. These valid concerns require careful consideration when implementing a PHR or patient portal into a practice. Providers will benefit from a clear understanding of actual compared with potential risks and benefits. Much of the concerns about the negative effect on providers' workload and the potential increase in patients' anxiety have not been borne out. On the other hand, the implementation strategy, governance structure, and end-user education are crucial components to ensuring success. Successful implementation of a PHR or patient portal affords the opportunity to improve patient satisfaction and increase efficiency in provider workflow. The possibility exists to improve patient outcomes by engaging the patient in decision making and follow through.

scholarly journals Continuity of care in Ghana: the promise of smart-med

2014 ◽  
Vol 3 (4) ◽  
pp. 473
Author(s):  
Henry Ogoe ◽  
Odame Agyapong ◽  
Fredrick Troas Lutterodt
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Continuity Of Care ◽  
Medical Information ◽  
Care Delivery ◽  
Personal Health Records ◽  
Personal Health ◽  
Care Providers ◽  
Health Records ◽  
Fragmentation Of Care

Individuals tend to receive medical care from different health care providers as they drift from one location to another. Oftentimes, multiple providers operate disparate systems of managing patients medical records. These disparate systems, which are unable to share and/or exchange information, have the propensity to create fragmentation of care, which poses a serious threat to the realization of continuity of care in the Ghanaian health care delivery. Continuity of care, which is the ability to seamlessly access, update, and manage patients medical information as they visit multiple providers, is a crucial component of quality of care in any health delivery system. The current system of managing patients records in Ghanapaper-basedmakes continuity of care difficult to actualize. To this end, we have developed a smartcard based personal health records system, SMART-MED, which can effectively promote continuity of care in Ghana. SMART-MED is platform-independent; it can run as standalone or configured to plug into any Java-based electronic medical record system. Results of a lab simulation test suggest that it can effectively promote continuity of care through improved data security, support interoperability for disparate systems, and seamless access and update of patients health records. Keywords: Continuity of Care, Fragmentation of Care, Interoperability, Personal Health Records, Smartcard.

scholarly journals Personal health records in the Netherlands: potential user preferences quantified by a discrete choice experiment

2016 ◽  
Vol 24 (3) ◽  
pp. 529-536 ◽  
Author(s):  
Domino Determann ◽  
Mattijs S Lambooij ◽  
Dorte Gyrd-Hansen ◽  
Esther W de Bekker-Grob ◽  
Ewout W Steyerberg ◽  
...  
Keyword(s):  
Health Care ◽  
Data Storage ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Health Care Providers ◽  
Choice Experiment ◽  
Personal Health Records ◽  
Personal Health ◽  
Care Providers ◽  
Health Records

Objective: To identify groups of potential users based on their preferences for characteristics of personal health records (PHRs) and to estimate potential PHR uptake. Methods: We performed a discrete choice experiment, which consisted of 12 choice scenarios, each comprising 2 hypothetical PHR alternatives and an opt-out. The alternatives differed based on 5 characteristics. The survey was administered to Internet panel members of the Dutch Federation of Patients and Consumer Organizations. We used latent class models to analyze the data. Results: A total of 1,443 potential PHR users completed the discrete choice experiment. We identified 3 latent classes: “refusers” (class probability 43%), “eager adopters” (37%), and “reluctant adopters” (20%). The predicted uptake for the reluctant adopters ranged from 4% in the case of a PHR with the worst attribute levels to 68% in the best case. Those with 1 or more chronic diseases were significantly more likely to belong to the eager adopter class. The data storage provider was the most decisive aspect for the eager and reluctant adopters, while cost was most decisive for the refusers. Across all classes, health care providers and independent organizations were the most preferred data storage providers. Conclusion: We identified 3 groups, of which 1 group (more than one-third of potential PHR users) indicated great interest in a PHR irrespective of PHR characteristics. Policymakers who aim to expand the use of PHRs will be most successful when health care providers and health facilities or independent organizations store PHR data while refraining from including market parties.

scholarly journals Viewpoint: Health literacy and patient portals

2015 ◽  
Vol 7 (2) ◽  
pp. 172 ◽  
Author(s):  
Yulong Gu ◽  
Martin Orr ◽  
Jim Warren
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Health Care Providers ◽  
Easy Access ◽  
Patient Portal ◽  
Care Providers ◽  
Patient Portals ◽  
Health Consumer ◽  
Improve Patient

Health literacy has been described as the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Improving health literacy may serve to promote concordance with therapy, engage patients in their own health care, and improve health outcomes. Patient portal technology aims at enabling patients and families to have easy access to key information in their own medical records and to communicate with their health care providers electronically. However, there is a gap in our understanding of how portals will improve patient outcome. The authors believe patient portal technology presents an opportunity to improve patient concordance with prescribed therapy, if adequate support is provided to equip patients (and family/carers) with the knowledge needed to utilise the health information available via the portals. Research is needed to understand what a health consumer will use patient portals for and how to support a user to realise the technology?s potential.

scholarly journals Making the Case for a P2P Personal Health Record

Information ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 512
Author(s):  
William Connor Horne ◽  
Zina Ben Miled
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Information ◽  
Third Party ◽  
Personal Health ◽  
Health Record ◽  
Care Providers ◽  
Health Records ◽  
Client Server ◽  
Proposed Model

Improved health care services can benefit from a more seamless exchange of medical information between patients and health care providers. This exchange is especially important considering the increasing trends in mobility, comorbidity and outbreaks. However, current Electronic Health Records (EHR) tend to be institution-centric, often leaving the medical information of the patient fragmented and more importantly inaccessible to the patient for sharing with other health providers in a timely manner. Nearly a decade ago, several client–server models for personal health records (PHR) were proposed. The aim of these previous PHRs was to address data fragmentation issues. However, these models were not widely adopted by patients. This paper discusses the need for a new PHR model that can enhance the patient experience by making medical services more accessible. The aims of the proposed model are to (1) help patients maintain a complete lifelong health record, (2) facilitate timely communication and data sharing with health care providers from multiple institutions and (3) promote integration with advanced third-party services (e.g., risk prediction for chronic diseases) that require access to the patient’s health data. The proposed model is based on a Peer-to-Peer (P2P) network as opposed to the client–server architecture of the previous PHR models. This architecture consists of a central index server that manages the network and acts as a mediator, a peer client for patients and providers that allows them to manage health records and connect to the network, and a service client that enables third-party providers to offer services to the patients. This distributed architecture is essential since it promotes ownership of the health record by the patient instead of the health care institution. Moreover, it allows the patient to subscribe to an extended range of personalized e-health services.

scholarly journals Section 1: Health and Clinical Management: Leveraging Information Technology to Improve Quality and Safety

2007 ◽  
Vol 16 (01) ◽  
pp. 22-29
Author(s):  
D. W. Bates ◽  
J. S. Einbinder
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Clinical Data ◽  
Data Exchange ◽  
Personal Health Records ◽  
Personal Health ◽  
Health Records ◽  
Provider Behavior ◽  
Published Research ◽  
Improve Patient

SummaryTo examine five areas that we will be central to informatics research in the years to come: changing provider behavior and improving outcomes, secondary uses of clinical data, using health information technology to improve patient safety, personal health records, and clinical data exchange.Potential articles were identified through Medline and Internet searches and were selected for inclusion in this review by the authors.We review highlights from the literature in these areas over the past year, drawing attention to key points and opportunities for future work.Informatics may be a key tool for helping to improve patient care quality, safety, and efficiency. However, questions remain about how best to use existing technologies, deploy new ones, and to evaluate the effects. A great deal of research has been done on changing provider behavior, but most work to date has shown that process benefits are easier to achieve than outcomes benefits, especially for chronic diseases. Use of secondary data (data warehouses and disease registries) has enormous potential, though published research is scarce. It is now clear in most nations that one of the key tools for improving patient safety will be information technology— many more studies of different approaches are needed in this area. Finally, both personal health records and clinical data exchange appear to be potentially transformative developments, but much of the published research to date on these topics appears to be taking place in the U.S.— more research from other nations is needed.

scholarly journals Use and Effects of Patient Access to Medical Records in General Practice Through a Personal Health Record in the Netherlands: Protocol for a Mixed-Methods Study

10.2196/10193 ◽  
2018 ◽  
Vol 7 (9) ◽  
pp. e10193 ◽  
Author(s):  
Maria MT Vreugdenhil ◽  
Rudolf B Kool ◽  
Kees van Boven ◽  
Willem JJ Assendelft ◽  
Jan AM Kremer
Keyword(s):  
Health Care ◽  
General Practice ◽  
Health Care Providers ◽  
Personal Health Record ◽  
Mixed Methods Study ◽  
Personal Health ◽  
Care Providers ◽  
Group Discussions ◽  
Web Based ◽  
Staff Level

Background In the Dutch health care system, general practitioners hold a central position. They store information from all health care providers who are involved with their patients in their electronic health records. Web-based access to the summary record in general practice through a personal health record (PHR) may increase patients’ insight into their medical conditions and help them to be involved in their care. Objective We describe the protocol that we will use to investigate the utilization of patients’ digital access to the summary of their medical records in general practice through a PHR and its effects on the involvement of patients in their care. Methods We will conduct a multilevel mixed-methods study in which the PHR and Web-based access to the summary record will be offered for 6 months to a random sample of 500 polypharmacy patients, 500 parents of children aged <4 years, and 500 adults who do not belong to the former two groups. At the patient level, a controlled before-after study will be conducted using surveys, and concurrently, qualitative data will be collected from focus group discussions, think-aloud observations, and semistructured interviews. At the general practice staff (GP staff) level, focus group discussions will be conducted at baseline and Q-methodology inquiries at the end of the study period. The primary outcomes at the patient level are barriers and facilitators for using the PHR and summary records and changes in taking an active role in decision making and care management and medication adherence. Outcomes at the GP staff level are attitudes before and opinions after the implementation of the intervention. Patient characteristics and changes in outcomes related to patient involvement during the study period will be compared between the users and nonusers of the intervention using chi-square tests and t tests. A thematic content analysis of the qualitative data will be performed, and the results will be used to interpret quantitative findings. Results Enrollment was completed in May 2017 and the possibility to view GP records through the PHR was implemented in December 2017. Data analysis is currently underway and the first results are expected to be submitted for publication in autumn 2019. Conclusions We expect that the findings of this study will be useful to health care providers and health care organizations that consider introducing the use of PHR and Web-based access to records and to those who have recently started using these. Trial Registration Netherlands Trial Registry NTR6395; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6395 (Archived by WebCite at http://www.webcitation.org/71nc8jzwM) Registered Report Identifier RR1-10.2196/10193

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

Personal Health Records Status-Quo and Future Perspectives

2010 ◽  
pp. 43-63
Author(s):  
Simon Y. Liu,
Keyword(s):  
Health Care ◽  
Health Information ◽  
Personal Health Record ◽  
Full Range ◽  
Personal Health Records ◽  
Controlled Vocabulary ◽  
Care Process ◽  
Personal Health ◽  
Health Records ◽  
Access To Health

Consumers, industry, and government have recently focused attention on the potential of personal health records to empower patients in the health care process, improve patient-provider relationships, facilitate patient access to health information, and improve the quality of health care. A Personal Health Record (PHR) is a private and secure digital record that is created, managed, and owned by an individual, and contains the owner’s relevant health information. The benefits of PHRs have not yet been widely realized due to several significant challenges in their adoption, including the need for privacy, security, and interoperability, and the lack of accepted standards. Although many players in the healthcare arena are beginning to offer partial solutions, none have adequately addressed the full range of challenges. The adoption of PHRs can be significantly accelerated by the development of Open Source software that enables an individual to collect, create, organize, and manage his or her own private and secure PHR, using a standardized format and controlled vocabulary.

Linking School Nurses With Health Care Systems Using EHRs: An Integrative Review

2020 ◽  
pp. 105984052091332
Author(s):  
Christina Baker ◽  
Bonnie Gance-Cleveland
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Health Care Team ◽  
School Nurses ◽  
Care Providers ◽  
Health Records ◽  
School Aged Children ◽  
Team Care ◽  
Care Systems

School-aged children spend around 1,080 hr at school each year and many of them have chronic diseases; therefore, it is imperative to include school nurses as part of the health care team. Care coordination between health care providers and school nurses is currently hindered by communication that relies on an inadequate system of fax, phone, and traditional mail. Using electronic health records (EHRs) to link school nurses and health care systems is usually limited in scope despite EHRs advancement in these health care systems. No literature is currently available showing the number of hospitals and health care systems that provide EHR access to school nurses. The purpose of this article was to present a literature review on EHR access for school nurses nationally. This review along with the legal and logistical considerations for this type of implementation will be discussed.

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