Discussion: NR 361 Your patient has a Personal Health Record… Now what?

Discussion: NR 361 Your patient has a Personal Health Record… Now what?

Discussion: NR 361 Your patient has a Personal Health Record… Now what?

What are the pros and cons of the situation in the case study? 

The implementation of EHRS in the medical field has provided many benefits for both patients and providers. This long list of benefits includes improved safety, easier access to a patient’s chart which allows for faster care, and improved control over health information for the consumer (Hebda and Hunter, 2019). There are many pros to this scenario. I would like to highlight the efficiency aspect that the patient can review the information received by their healthcare provider as quickly as they can log in. The information can be reviewed multiple times for the patient to obtain a better understanding of their results and condition. The patient can easily share accurate information with the family and other providers. The patient’s ability to recollect what has been said to them by the provider may be altered for many reasons so the PHR is a great place to review. The PHR can be a reminder for symptoms that need to be reported, follow-up appointments, and new questions that may arise after the provider contact. In general, a tool to promote patient involvement. The greatest con to the scenario is that the patient was not able to access all their information in one place. As explained by (Lester M, Boateng S, Studeny J, and Coustasse A), some standards support interoperability and have started to take hold in the realm of PHRs. Blue Button and direct secure messaging are two such examples that have been incorporated into many PHR systems (2016). I am surprised by all the ways technology has advanced that we are not all using a system to universally integrate the different EHR’s. If this were the case it would make the patient experience more complete and the usability of the PHR more meaningful.

What safeguards are included inpatient portals and PHRs to help patients and healthcare professionals ensure safety? 

There are many safeguards in place to help both patients and healthcare providers. When accessing a PHR there are security questions, PINs, and MRN numbers that are specific to the patient. The providers entering information also have passcodes specific to them when entering information so this data can be traced back to the author. These safeguards not only help keep information confidential but also accurate.

Do you agree or disagree with the way that a patient obtains Personal Health Records (PHRs)?

 I agree with the right of a patient to have access to their information. As we develop and improve upon the PHR it will become more useful and effective for this objective. Allowing a patient to review their records can help them gain better insight into their health. This can allow them to develop questions for the next visit and help them be better informed regarding decisions and the direction of their care.

What are the challenges for patients that do not have access to all the PHRs?

 Remember, only portions of the EHRs are typically included in the PHRs. The great challenges for patients not being able to access all their information revolve around them not seeing the complete picture. It will be hard for them to understand a holistic approach to healthcare decision-making if they do not see all the pieces of the puzzle. If information is not in the PHR then it is the healthcare provider’s responsibility to inform and explain what is missing. I have had patients pull all this information together into spreadsheets. They bring the spreadsheets with them when they are admitted to the hospital and it makes the admission process much more efficient and smoother. This affects the quality of care and patient satisfaction in their stay.

References

Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses & healthcare professionals (6th ed.). New York, NY: Pearson.

Lester M, Boateng S, Studeny J, and Coustasse A, (April 2016) Personal Health Records: Beneficial or Burdensome for Patients and Healthcare Providers? Retrieved July 27, 2020, from https://chamberlain-on-worldcat-org.chamberlainuniversity.idm.oclc.org/oclc/6031930212

Discussion: NR 361 Your patient has a Personal Health Record… Now what?

NR361 RN Information Systems in Healthcare

• • Week 4 Discussion Post:

    What are the pros and cons of the situation in the case study?

    A patient has access to some of their medical data as entered by their healthcare provider via their Personal Health Record (PHR) (Hebda, Hunter, & Czar, 2019, p. 113). The pros of PHRs are that the patient can communicate with their provider as well as have access some of their medical records, therefore allowing the patient to be more aware and involved in their care. The cons for this situation are that the patient was not able to access their full medical records. The fact that the patient was only able to access a portion of her lab results can make the patient more apprehensive about what they weren’t able to see. I believe this can cause the patient to speculate more about what the possible missing results are.

    What safeguards are included in patient portals and PHRs to help patients and healthcare professionals ensure safety?

    In order to access one’s own PHR portal, the individual most first sign multiple waivers at their healthcare provider’s facility. Usually this includes a Health Insurance Portability and Accountability Act (HIPAA) disclosure and a waiver from the application or program used to access the PHR (Lester, Boateng, Studeny, & Coustasse, 2016). Once the waivers have been signed, the patient then selects a username and password using security questions and a personal email.

    Do you agree or disagree with the way that a patient obtains Personal Health Records (PHRs)?

    I agree with the current practices used for patients to obtain PHRs. I appreciate that this is optional for patients, and not the only way to access these records. There is still a population of patients who wish to keep track of their medical records in paper form instead of electronically. In the future, I believe technology will advance to where all medical records can be added to a universal database that is accessible by patients and healthcare providers from different institutions, seamlessly.

    What are challenges for patients that do not have access to all of the PHRs? Remember, only portions of the EHRs are typically included in the PHRs.

    The challenge for patients that do not have access to all of the PHRs is that all information that is a part of their Electronic Health Record (EHR) does not automatically become a part of their PHR. This situation highlights the worst part of PHRs, which is that separate institutions do not share results and medical records automatically. PHR databases are not perfect and may not include the complete results and reports, which can be troublesome. For patients who want complete medical records, they should stick with old-fashioned paper copies of their medical records.

    References

    Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses & healthcare professionals (6th ed.). Pearson.

    Lester, M., Boateng, S., Studeny, J., & Coustasse, A. (2016). Personal Health Records: Beneficial or Burdensome for Patients and Healthcare Providers?. Perspectives in health information management, 13 (Spring), 1h.

     
     

Week 4 Discussion

Your patient has a Personal Health Record… Now what?

Purpose

This week’s graded discussion topic relates to the following Course Outcomes (COs).

CO4 Investigate safeguards and decision-making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers. (PO 4)

CO5 Identify patient care technologies, information systems, and communication devices that support safe nursing practice. (PO 5)

Directions

Discussions are designed to promote dialogue between faculty and students, and students and their peers. In discussions students:

Demonstrate understanding of concepts for the week

Integrate scholarly resources

Engage in meaningful dialogue with classmates

Express opinions clearly and logically, in a professional manner

Use the rubric on this page as you compose your answers.

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Discussion Question

Case Study: A 65-year-old woman was just been diagnosed with Stage 3 non-Hodgkin’s lymphoma. She was informed of this diagnosis in her primary care physician’s office. She leaves her physician’s office and goes home to review all of her tests and lab results with her family. She goes home and logs into her PHR. She is only able to pull up a portion of her test results. She calls her physician’s office with this concern. The office staff discussed that she had part of her lab work completed at a lab not connected to the organization, part was completed at the emergency room, and part was completed in the lab that is part of the doctor’s office organization.

The above scenario might be a scenario that you have commonly worked with in clinical practice. For many reasons, patients often receive healthcare from multiple organizations that might have different systems.

As you review this scenario, reflect and answer these questions for this discussion.

What are the pros and cons of the situation in the case study?

What safeguards are included in patient portals and PHRs to help patients and healthcare professionals ensure safety?

Do you agree or disagree with the way that a patient obtains Personal Health Records (PHRs)?

What are challenges for patients that do not have access to all of the PHRs? Remember, only portions of the EHRs are typically included in the PHRs.