scholarly journals Ready for Prime Time? Using Normalization Process Theory to Evaluate Implementation Success of Personal Health Records Designed for Decision Making

2020 ◽  
Vol 2 ◽  
Author(s):  
Selena Davis
Keyword(s):  
Decision Making ◽  
Personal Health Records ◽  
Normalization Process Theory ◽  
Process Theory ◽  
Personal Health ◽  
Health Record ◽  
Care Providers ◽  
Implementation Success ◽  
Health Records ◽  
Normalization Process

Personal health records designed for shared decision making (SDM) have the potential to engage patients and provide opportunities for positive health outcomes. Given the limited number of published interventions that become normal practice, this preimplementation evaluation of an integrated SDM personal health record system (e-PHR) was underpinned by Normalization Process Theory (NPT). The theory provides a framework to analyze cognitive and behavioral mechanisms known to influence implementation success. A mixed-methods investigation was utilized to explain the work required to implement e-PHR and its potential to integrate into practice. Patients, care providers, and electronic health record (EHR) and clinical leaders (n = 27) offered a rich explanation of the implementation work. Reliability tests of the NPT-based instrument negated the use of scores for two of the four mechanisms. Participants indicated that e-PHR made sense as explained by two qualitative themes: game-changing technology and sensibility of change. Participants appraised e-PHR as explained by two themes: reflecting on value and monitoring and adapting. The combined qualitative and quantitative results for the other two NPT mechanisms corroborated. Participants strongly agreed (score = 4.6/5) with processes requiring an investment in commitment, explained by two themes: sharing ownership of the work and enabling involvement. Weak agreement (score = 3.6/5) was observed with processes requiring an investment in effort, explained by one theme: uncovering the challenge of building collective action, and three subthemes: assessing fit, adapting to change together, and investing in the change. Finally, participants strongly agreed (score = 4.5/5) that e-PHR would positively affect engagement in self-management decision-making in two themes: care is efficient, and care is patient-centered. Overall, successful integration of e-PHR will only be attained when systemic effort is invested to enact it. Additional investigation is needed to explore the collective action gaps to inform priorities and approaches for future implementation success. This research has implications for patients, care providers, EHR vendors, and the healthcare system for improving the effectiveness and efficiency of patient-centric services. Findings confirm the usefulness of NPT for planning and understanding implementation success of PHRs.

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.

Personal Health Records Systems Go Mobile

2011 ◽  
pp. 750-772
Author(s):  
Phillip Olla ◽  
Joseph Tan
Keyword(s):  
Health Information ◽  
Mobile Device ◽  
Personal Health Record ◽  
Personal Health Records ◽  
Personal Health ◽  
Health Record ◽  
Health Records ◽  
Extant Literature ◽  
The Past ◽  
Secure Environment

This chapter provides an overview of mobile personal health record (MPHR) systems. A Mobile personal health record is an eclectic application through which patients can access, manage, and share their health information from a mobile device in a private, confidential, and secure environment. Personal health records have evolved over the past three decades from a small card or booklet with immunizations recorded into fully functional mobile accessible portals, and it is the PHR evolution outside of the secure healthcare environment that is causing some concerns regarding privacy. Specifically, the chapter reviews the extant literature on critical evaluative components to be considered when assessing MPHR systems.

Privacy concerns of the Australian My Health Record: Implications for other large-scale opt-out personal health records

2020 ◽  
Vol 57 (6) ◽  
pp. 102364 ◽  
Author(s):  
Patrick Cheong-Iao Pang ◽  
Dana McKay ◽  
Shanton Chang ◽  
Qingyu Chen ◽  
Xiuzhen Zhang ◽  
...  
Keyword(s):  
Large Scale ◽  
Personal Health Records ◽  
Personal Health ◽  
Health Record ◽  
Health Records ◽  
Privacy Concerns ◽  
Opt Out

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 Aplikasi e-Health Berbasis Teknologi Smartphone dalam Monitoring Klien di Komunitas: Studi Literatur

2020 ◽  
Vol 11 (2) ◽  
pp. 120
Author(s):  
Rohayati Rohayati
Keyword(s):  
Health Status ◽  
Health Monitoring ◽  
Health Workers ◽  
Personal Health Record ◽  
Personal Health Records ◽  
The Internet ◽  
Personal Health ◽  
Health Record ◽  
Health Records ◽  
Mobile Health Monitoring

The e-health is information technology in the health systems that can be used by both health workers and clients. Ehealth applications can be based on computers, the internet or smartphones. This study aims to discuss the types of e-health that can be used for health monitoring using smartphones in community setting. Data collection was carried out through electronic database, namely EBSCO, Proquest, Sciencedirect, Scopus, Springerlink and Google Scholar. The e-health that can be used to carry out health promotion and monitor the health status of clients was remote mobile health monitoring. This application was integrated with the internet and smartphone so that clients and health workers can monitor the development of the client's health status. The application that can be used to document medical history was a personal health record both internet and computer integrated so that it can be accessed by clients. Community nurses and primary care institutions are expected to be able to design and use this application to monitor and record the health status of clients in the community. Keywords: e-health in community; smartphone; personal health records ABSTRAK Teknologi e-health merupakan teknologi informasi di bidang kesehatan yang dapat digunakan baik oleh petugas kesehatan maupun klien. Aplikasi e-health dapat berbasis komputer, internet maupun smartphone. Studi ini bertujuan untuk membahas jenis-jenis e-health yang dapat digunakan untuk monitoring kesehatan menggunakan smartphone. Pengumpulan data dilakukan melalui telaah literatur jurnal elektronik yaitu EBSCO, Proquest, Science direct, Scopus, Springerlink dan Google Scholar. Teknologi e-health yang dapat digunakan untuk melakukan promosi kesehatan, memonitor status kesehatan klien adalah remote mobile health monitoring. Aplikasi ini terintegrasi dengan internet dan smartphone sehingga klien dan petugas kesehatan dapat memonitor perkembangan status kesehatan klien dimanapun berada. Aplikasi yang dapat digunakan untuk melakukan dokumentasi riwayat kesehatan adalah personal health record baik terintegrasi internet maupun komputer sehingga dapat diakses oleh klien. Perawat komunitas dan institusi pelayanan primer diharapkan dapat merancang dan menggunakan aplikasi ini untuk memonitor dan mencatat status kesehatan klien di masyarakat. Kata kunci: e-health di komunitas; smartphone; personal health records

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.

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