scholarly journals An Overview Of Consumer Perceptions And Acceptance As Well As Barriers And Potential Of Electronic Personal Health Records

2011 ◽  
Vol 2 (2) ◽  
pp. 45-52 ◽  
Author(s):  
Brett Pirtle ◽  
Ashish Chandra
Keyword(s):  
Personal Health Record ◽  
Error Rates ◽  
Security And Privacy ◽  
Personal Health ◽  
Privacy And Security ◽  
Health Records ◽  
Data Formats ◽  
Electronic Personal Health Record ◽  
Electronic Personal Health Records ◽  
Ehr Adoption

Healthcare industry leaders, government agencies and the general public are beginning to see the value that Electronic Health Records (EHR) systems bring through increased quality, reduced medical error rates, and improved care coordination. One subset of the EHR, known as the electronic personal health record (PHR), is gaining in popularity. Before PHRs will be widely adopted, many barriers to their use must be overcome. These include the costs to the developer, host, and patient. Patient access to electronic resources is a concern. Interoperability is another problem. It is not practical for physicians to convert different data formats so that different PHRs may be adopted. Finally, privacy and security concerns also impact EHR adoption. Patients want assurance that their data is secure and not used for marketing purposes. Despite these barriers, there is high consumer interest in PHR products. In future, it is expected that PHR programs will be certified, security and privacy will be enforced by legislation, and standards for interoperability will be developed. PHR will also incorporate additional decision support aids and may become part of a social network that promotes peer support for positive behavior change. This paper will provide an overview of all these issues pertaining to PHR.

scholarly journals A pilot study to evaluate the magnitude of association of patient activation in HIV-infected veterans who use electronic personal health records

2014 ◽  
Author(s):  
Pierre-Cedric Crouch ◽  
Carol PhD, RN, FAAN Dawson Rose ◽  
Mallory I. Johnson ◽  
Susan Janson
Keyword(s):  
Health Care ◽  
Viral Load ◽  
Personal Health Record ◽  
Patient Activation ◽  
Personal Health Records ◽  
Personal Health ◽  
Health Record ◽  
Health Records ◽  
Electronic Personal Health Record ◽  
Electronic Personal Health Records

Background: The HITECH Act signed into law in 2009 requires hospitals to provide patients with electronic access to their health information through an electronic personal health record (ePHR) in order to receive Medicare/Medicaid incentive payments. Little is known about who uses these systems or the impact these systems will have on patient outcomes in HIV care. The health care empowerment model provides rationale for the hypothesis that knowledge from an electronic personal health record can lead to greater patient empowerment resulting in improved outcomes. Objective: To determine the patient characteristics and patient activation, empowerment, satisfaction, knowledge of their CD4, Viral Loads, and antiretroviral medication, and medication adherence outcomes associated with electronic personal health record use in Veterans living with HIV at the San Francisco VA Medical Center. Participants: HIV-Infected Veterans receiving care in a low volume HIV-clinic at the San Francisco VA Medical Center, divided into two groups of users and non-users of electronic personal health records. Methods: In-person surveys were completed either online or on paper and data abstraction was completed from medical records for current anti-retroviral therapy (ART), CD4 count, and plasma HIV-1 viral load. Measures: The measures included the Patient Activation Measure, Health Care Empowerment Inventory, ART adherence, provider satisfaction, current CD4 count, current plasma viral load, knowledge of current ART, knowledge of CD4 counts, and knowledge of viral load. Results: In all, 40 participants were recruited. The use of electronic personal health records was associated with significantly higher levels of patient activation and levels of patient satisfaction for getting timely appointments, care, and information. ePHR was also associated with greater proportions of undetectable plasma HIV-1 viral loads, of knowledge of current CD4 count, and of knowledge of current viral load. The two groups differed by race and computer access. There was no difference in the current CD4, provider satisfaction, Health Care Empowerment Inventory score, satisfaction with provider-patient communication, satisfaction with courteous and helpful staff, knowledge of ART, or ART adherence. Conclusions: The use of electronic personal health records is associated with positive clinical and behavioral characteristics. The use of these systems may play a role in improving the health of people with HIV. Larger studies are needed to further evaluate these associations.

scholarly journals A pilot study to evaluate the magnitude of association of patient activation in HIV-infected veterans who use electronic personal health records

2014 ◽  
Author(s):  
Pierre-Cedric Crouch ◽  
Carol PhD, RN, FAAN Dawson Rose ◽  
Mallory I. Johnson ◽  
Susan Janson
Keyword(s):  
Health Care ◽  
Viral Load ◽  
Personal Health Record ◽  
Patient Activation ◽  
Personal Health Records ◽  
Personal Health ◽  
Health Record ◽  
Health Records ◽  
Electronic Personal Health Record ◽  
Electronic Personal Health Records

Background: The HITECH Act signed into law in 2009 requires hospitals to provide patients with electronic access to their health information through an electronic personal health record (ePHR) in order to receive Medicare/Medicaid incentive payments. Little is known about who uses these systems or the impact these systems will have on patient outcomes in HIV care. The health care empowerment model provides rationale for the hypothesis that knowledge from an electronic personal health record can lead to greater patient empowerment resulting in improved outcomes. Objective: To determine the patient characteristics and patient activation, empowerment, satisfaction, knowledge of their CD4, Viral Loads, and antiretroviral medication, and medication adherence outcomes associated with electronic personal health record use in Veterans living with HIV at the San Francisco VA Medical Center. Participants: HIV-Infected Veterans receiving care in a low volume HIV-clinic at the San Francisco VA Medical Center, divided into two groups of users and non-users of electronic personal health records. Methods: In-person surveys were completed either online or on paper and data abstraction was completed from medical records for current anti-retroviral therapy (ART), CD4 count, and plasma HIV-1 viral load. Measures: The measures included the Patient Activation Measure, Health Care Empowerment Inventory, ART adherence, provider satisfaction, current CD4 count, current plasma viral load, knowledge of current ART, knowledge of CD4 counts, and knowledge of viral load. Results: In all, 40 participants were recruited. The use of electronic personal health records was associated with significantly higher levels of patient activation and levels of patient satisfaction for getting timely appointments, care, and information. ePHR was also associated with greater proportions of undetectable plasma HIV-1 viral loads, of knowledge of current CD4 count, and of knowledge of current viral load. The two groups differed by race and computer access. There was no difference in the current CD4, provider satisfaction, Health Care Empowerment Inventory score, satisfaction with provider-patient communication, satisfaction with courteous and helpful staff, knowledge of ART, or ART adherence. Conclusions: The use of electronic personal health records is associated with positive clinical and behavioral characteristics. The use of these systems may play a role in improving the health of people with HIV. Larger studies are needed to further evaluate these associations.

scholarly journals Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review

2020 ◽  
Author(s):  
Zahra Niazkhani ◽  
Esmaeel Toni ◽  
Mojgan Cheshmekaboodi ◽  
Andrew Georgiou ◽  
Habibollah Pirnejad
Keyword(s):  
Chronic Disease ◽  
Computer Literacy ◽  
Chronic Care ◽  
Personal Health Records ◽  
Personal Health ◽  
Cochrane Central Register ◽  
Privacy And Security ◽  
Health Records ◽  
Chronic Disease Care ◽  
Electronic Personal Health Records

Abstract Background: Electronic personal health records (ePHRs) are defined as electronic applications through which individuals can access, manage, and share health information in a private, secure, and confidential environment. Existing evidence shows their benefits in improving outcomes, especially for chronic disease patients. However, their use has not been as widespread as expected partly due to barriers faced in their adoption and use. We aimed to identify the types of barriers to a patient, provider, and caregiver adoption/use of ePHRs and to analyze their extent in chronic disease care.Methods: A systematic search in Medline, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, and the Institute of Electrical and Electronics Engineers (IEEE) database was performed to find original studies assessing barriers to ePHR adoption/use in chronic care until the end of 2018. Two researchers independently screened and extracted data. We used the PHR adoption model and the Unified Theory of Acceptance and Use of Technology to analyze the results. The Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the quality of evidence in the included studies.Results: Sixty publications met our inclusion criteria. Issues found hindering ePHR adoption/use in chronic disease care were associated with demographic factors (e.g., patient age and gender) along with key variables related to health status, computer literacy, preferences for direct communication, and patient’s strategy for coping with a chronic condition; as well as factors related to medical practice/environment (e.g., providers’ lack of interest or resistance to adopting ePHRs due to workload, lack of reimbursement, and lack of user training); technological (e.g., concerns over privacy and security, interoperability with electronic health record systems, and lack of customized features for chronic conditions); and chronic disease characteristics (e.g., multiplicities of co-morbid conditions, settings, and providers involved in chronic care).Conclusions: ePHRs can be meaningfully used in chronic disease care if they are implemented as a component of comprehensive care models specifically developed for this care. Our results provide insight into hurdles and barriers mitigating ePHR adoption/use in chronic disease care. A deeper understating of the interplay between these barriers will provide opportunities that can lead to an enhanced ePHR adoption/use.

scholarly journals Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review

2020 ◽  
Author(s):  
Zahra Niazkhani ◽  
Esmaeel Toni ◽  
Mojgan Cheshmekaboodi ◽  
Andrew Georgiou ◽  
Habibollah Pirnejad
Keyword(s):  
Chronic Disease ◽  
Computer Literacy ◽  
Chronic Care ◽  
Personal Health Records ◽  
Personal Health ◽  
Cochrane Central Register ◽  
Privacy And Security ◽  
Health Records ◽  
Chronic Disease Care ◽  
Electronic Personal Health Records

Abstract Background Electronic personal health records (ePHRs) are defined as electronic applications through which individuals can access, manage, and share health information in a private, secure, and confidential environment. Existing evidence shows their benefits in improving outcomes, especially for chronic disease patients. However, their use has not been as widespread as expected partly due to barriers faced in their adoption and use. We aimed to identify the types of barriers to a patient, provider, and caregiver adoption/use of ePHRs and to analyze their extent in chronic disease care.Methods A systematic search in Medline, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, and the Institute of Electrical and Electronics Engineers (IEEE) database was performed to find original studies assessing barriers to ePHR adoption/use in chronic care until the end of 2018. Two researchers independently screened and extracted data. We used the PHR adoption model and the Unified Theory of Acceptance and Use of Technology to analyze the results. The Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the quality of evidence in the included studies.Results Sixty publications met our inclusion criteria. Issues found hindering ePHR adoption/use in chronic disease care were associated with demographic factors (e.g., patient age and gender) along with key variables related to health status, computer literacy, preferences for direct communication, and patient’s strategy for coping with a chronic condition; as well as factors related to medical practice/environment (e.g., providers’ lack of interest or resistance to adopting ePHRs due to workload, lack of reimbursement, and lack of user training); technological (e.g., concerns over privacy and security, interoperability with electronic health record systems, and lack of customized features for chronic conditions); and chronic disease characteristics (e.g., multiplicities of co-morbid conditions, settings, and providers involved in chronic care).Conclusions ePHRs can be meaningfully used in chronic disease care if they are implemented as a component of comprehensive care models specifically developed for this care. Our results provide insight into hurdles and barriers mitigating ePHR adoption/use in chronic disease care. A deeper understating of the interplay between these barriers will provide opportunities that can lead to an enhanced ePHR adoption/use.

scholarly journals Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review

2020 ◽  
Author(s):  
Zahra Niazkhani ◽  
Esmaeel Toni ◽  
Mojgan Cheshmekaboodi ◽  
Andrew Georgiou ◽  
Habibollah Pirnejad
Keyword(s):  
Chronic Disease ◽  
Computer Literacy ◽  
Chronic Care ◽  
Personal Health Records ◽  
Personal Health ◽  
Cochrane Central Register ◽  
Privacy And Security ◽  
Health Records ◽  
Chronic Disease Care ◽  
Electronic Personal Health Records

Abstract Background Electronic personal health records (ePHRs) are defined as electronic applications through which individuals can access, manage and share health information in a private, secure, and confidential environment. Existing evidence shows their benefits in improving outcomes especially for chronic disease patients. However, their use has not been as widespread as expected partly due to barriers faced in their adoption and use. We aimed to identify the types of barriers to patient, provider, and caregiver adoption/use of ePHRs and to analyze their extent in chronic disease care. Methods A systematic search in Medline, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, and the Institute of Electrical and Electronics Engineers (IEEE) dtabase was performed to find original studies assessing barriers to ePHR adoption/use in chronic care till the end of 2018. Two researchers independently screened and extracted data. We used the PHR adoption model and the Unified Theory of Acceptance and Use of Technology to analyze the results. The MMAT was used to assess the quality of evidence. Results Sixty publications met our inclusion criteria. Issues found hindering ePHR adoption/use in chronic disease care were associated with demographic factors (e.g., patient age and gender) along with key variables related to health status, computer literacy, preferences for direct communication, and patient’s strategy for coping with a chronic condition; as well as factors related to medical practice/environment (e.g., providers’ lack of interest or resistance to adopting ePHRs due to workload, lack of reimbursement, and user training); technological (e.g., concerns over privacy and security, interoperability with electronic health record systems, and lack of customized features for chronic conditions); and chronic disease characteristics (e.g., multiplicities of co-morbid conditions, settings and providers involved in chronic care). Conclusions ePHRs can be meaningfully used in chronic disease care if they are implemented as a component of comprehensive care models specifically developed for this care. Our results provide insight into hurdles and barriers mitigating ePHR adoption/use in chronic disease care. Deeper understating of the interplay between these barriers will provide opportunities that can lead to an enhanced ePHR adoption/use.

scholarly journals Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review

2020 ◽  
Author(s):  
Zahra Niazkhani ◽  
Esmaeel Toni ◽  
Mojgan Cheshmekaboodi ◽  
Andrew Georgiou ◽  
Habibollah Pirnejad
Keyword(s):  
Chronic Disease ◽  
Computer Literacy ◽  
Chronic Care ◽  
Personal Health Records ◽  
Personal Health ◽  
Cochrane Central Register ◽  
Privacy And Security ◽  
Health Records ◽  
Chronic Disease Care ◽  
Electronic Personal Health Records

Abstract Background Existing evidence shows benefits of electronic personal health records (PHRs) in improving outcomes for chronic disease patients. However, its use has not been as widespread as expected. We aimed to review barriers to patient, provider, and caregiver adoption/use of PHRs in chronic disease care. Methods A systematic search in Medline, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, and the Institute of Electrical and Electronics Engineers (IEEE) dtabase was performed to find original studies assessing barriers to PHR adoption/use in chronic care till the end of 2018. Two researchers independently screened and extracted data. We used the PHR adoption model and the Unified Theory of Acceptance and Use of Technology to analyze the results. The mixed methods appraisal tool (MMAT) version 2018 was used to assess the quality of evidence in included studies. Results Sixty publications met our inclusion criteria. Issues found hindering PHR adoption/use in chronic disease care were associated with demographic factors (e.g., patient age and gender) along with key variables related to health status, computer literacy, preferences for direct communication, and patient’s strategy for coping with a chronic condition; as well as factors related to medical practice/environment (e.g., providers’ lack of interest or resistance to adopting PHRs due to workload, lack of reimbursement, and lack of user training); technological (e.g., concerns over privacy and security, interoperability with electronic health record systems, and lack of customized features for chronic conditions); and chronic disease characteristics (e.g., multiplicities of co-morbid conditions, settings and providers involved in chronic care). Conclusions PHRs can be meaningfully used in chronic disease care if they are implemented as a component of comprehensive care models specifically developed for this care. Our results provide insight into hurdles and barriers mitigating PHR adoption/use in chronic disease care. Deeper understating of the interplay between these barriers will provide opportunities that can lead to an enhanced PHR adoption/use in chronic disease care.

scholarly journals Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health

2015 ◽  
Vol 06 (02) ◽  
pp. 224-247 ◽  
Author(s):  
A.M. Trinkoff ◽  
C.L. Storr ◽  
M.L. Wilson ◽  
A.P. Gurses ◽  
K. Gartrell
Keyword(s):  
Role Models ◽  
Data Privacy ◽  
Personal Health Record ◽  
Personal Health ◽  
Health Record ◽  
Privacy And Security ◽  
Convenience Sample ◽  
Electronic Personal Health Record ◽  
Health Promoting ◽  
Acceptance Model

SummaryBackground: To our knowledge, no evidence is available on health care professionals’ use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses’ personal use of ePHRs using a modified technology acceptance model.Objectives: To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses’ own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers’ use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use.Methods: A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect.Results: Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses’ own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses.Conclusions: Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their individual patients.Citation: Gartrell K, Trinkoff AM, Storr CL, Wilson ML, Gurses AP. Testing the electronic personal health record acceptance model by nurses for managing their own health: A cross-sectional survey. Appl Clin Inf 2015; 6: 224–247http://dx.doi.org/10.4338/ACI-2014-11-RA-0107

scholarly journals Meaningful Use of an Electronic Personal Health Record (ePHR) among Pediatric Cancer Survivors

2017 ◽  
Vol 26 (01) ◽  
pp. 250-264 ◽  
Author(s):  
Rebecca S Williamson ◽  
Brooke O Cherven ◽  
Jordan Gilleland Marchak ◽  
Paula Edwards ◽  
Michael Palgon ◽  
...  
Keyword(s):  
Young Adult ◽  
Personal Health Record ◽  
Adult Survivors ◽  
Personal Health ◽  
Adult Care ◽  
Adolescent Cancer ◽  
Increased Risk ◽  
Electronic Personal Health Records ◽  
Young Adult Survivors ◽  
To Receive

Summary Background and Objectivs: Survivors of pediatric and adolescent cancer are at an increased risk of chronic and debilitating health conditions and require life-long specialized care. Stand-alone electronic personal health records (ePHRs) may aid their self-management. This analysis characterizes young adult survivors and parents who meaningfully use an ePHR, Cancer SurvivorLinkTM, designed for survivors of pediatric and adolescent cancer. Methods: This was a retrospective observational study of patients seen at a pediatric survivor clinic for annual survivor care. Young adult survivors and/or parent proxies for survivors <18 years old who completed ePHR registration prior to their appointment or within 90 days were classified as registrants. Registrants who uploaded or downloaded a document and/or shared their record were classified as meaningful users. Results: Overall, 23.7% (148/624) of survivors/parents registered and 38% of registrants used SurvivorLink meaningfully. Young adult registrants who transferred to adult care during the study period were more likely to be meaningful users (aOR: 2.6 (95% CI: 1.1, 6.1)) and used the ePHR twice as frequently as those who continued to receive care in our institution’s pediatric survivor clinic. Among survivors who continued to receive care at our institution, being a registrant was associated with having an annual follow-up visit (aOR: 2.6 (95% CI: 1.2, 5.8)). Conclusions: While ePHRs may not be utilized by all survivors, SurvivorLink is a resource for a subset and may serve as an important bridge for patients who transfer their care. Using SurvivorLink was also associated with receiving recommended annual survivor care.

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