The advance in
communications technology and devices have made wireless electronic
communication possible in most parts of the world and at any time of the day.
With healthcare trends moving towards patient-centered care which empowers
patients and encourages patient-provider communications as a way to lower
healthcare costs and improve health outcomes. The increase in internet access
and the emergence of electronic health record has created new avenues for
patients to play an active role in their care.
Most Electronic Health Records (EHR) vendors have developed
patient portals to help patients electronically communicate with their
physicians or healthcare providers via smartphone applications or on a personal
computer giving them the ability to access and securely share their medical
records.
This portal is known as the Patient Health Records (PHR). The
Markle Foundation in 2004 initially defined PHR as “an electronic application
through which individuals can access, manage, and share their health
information, and that of others for whom they are authorized, in a private,
secure, and confidential environment. This was later redefined by the American
Health Information Management Association (AHIMA) as a lifelong electronic
resource of health information needed by individuals to make health decisions
guided by these principles, individuals owning and managing their information,
which comes from healthcare providers and the individual themselves.
The Health Information Technology for Economic and Clinical Health
(HITECH) Act of 2009 played an essential role in proliferating the use of
patient health records data. It provided incentives that helped to promote
meaningful use of EHR by health systems which drove the adoption of this health
technology to an all-time high in the United States.
These PHR systems create a platform that supports the vision of
health services that empower patients and enables patient-provider
communication, intending to improve health outcomes and cost reduction. Some
functions that exist on PHR platforms include EHR-transmitted data like
laboratory results and summary of care, appointment scheduling, prescription
refill, and secure messaging. Through the PHR portals, patients can track their
information to promote self-management, and securely share records when needed
with other healthcare professionals at different institutions.
As more patients begin to take control of their care, it is
essential to know if these information technology options are meeting the
expected effective communication between user and doctor to improve health
outcomes in patients.
The Office of the National Coordinator for Health Information
Technology (ONC) data brief of 2017 shows that fifty-two percent of individuals
in the United States have been offered online access to their medical records
by their health providers, with half of them viewing the contents of these
records representing twenty-eight percent nationwide. Among those who accessed
their online medical record, eight in ten considered their experience with the
online medical record to be easy to understand and useful. Among those that did
not access the online medical record offered to them, three-quarters cited
their preference to speak with their health care provider directly as a reason
for not using it. A quarter of them was concerned about the privacy and
security of online medical records. A significant number of those who accessed
their online medical records used it to monitor their health and to inform
treatment decisions.
Some of the latest systemic reviews have found no consistent
objective benefit attributable to PHR platforms and have recommended for more
work to be done to establish this theory.
Significant barriers to the utilization of online medical
records include concerns about security and privacy, limited technological
proficiency, and a desire to preserve in-person aspects of existing
patient-provider relationships.
I conducted an individual survey using an online website
questionnaire developed in the google form application to access the
utilization of PHR in my community. The survey tool contained demographics
questions (age, race/ethnicity, gender), access to online medical records,
utilization, and ease of use. The questions were adopted from the medical
records section of the Health Information National Trends Survey (HINTS)
instrument.
FINDINGS
The study shows that 83% of respondents said they had been
offered online access to their medical records by a health care provider or
insurer. This is a significant increase from the 2017 study with had 52% giving
the same response. Among the number of people that were offered access to their
online medical record, 66% viewed their record at least once, within the past
year.
The top reason cited by individuals for not accessing their online medical records with the past year was due to preference to speak directly to a provider.
|
How online medical record was used |
% of individuals who accessed online medical
record at least once |
|
To look up test results |
49% |
|
To request refill of medications |
20% |
|
Communicate with provider via secure messaging |
17% |
|
Update or correct medical record |
6% |
|
Monitor health or use for informing treatment decisions |
3% |
|
Download online medical record |
6% |
About half of those who accessed their online medical record
used it to look up test results, 20 percent of them responded that they used it
to refill medical prescriptions, and 17 percent used it to communicate with
health care providers via secure messaging.
The study found that a vast majority of respondents that
accessed their PHR (97%) reported perceived ease of use of the online medical
record platform, and 96 percent of individuals reported that their online
medical record was useful for monitoring their health.
Overall, the result shows that there is an increase in the
number of people that have been offered access to an online medical record by
either health care providers or insurers. This increase in access is reflected
in the percentage of individuals that used the online medical record for its
different functions. It is expected that with more individuals being offered
access to their online medical records we are going to see a major increase in
the number of individuals utilizing this platform for monitoring and making
health care decisions.
Another significant finding is that similar to other past survey
reports, individuals who did not access their online medical records despite
being offered stated a preference to speak with health care providers directly
as a significant reason. This means that they do not fully understand the
functions of the online medical record and believe it to be a replacement
rather than an added means of communication with health care providers. Some
people will still prefer to speak to health care providers directly as they see
the platform as a replacement for this function.
CONCLUSION
The use of online medical records is growing fast with
individuals and caregivers working as partners in the management of their
health care needs. With increased access to the online medical record, the
utilization of these patient portals has grown exponentially with the use of
standard functions like checking of laboratory results, prescription refill,
communication via secure messaging, and viewing clinical summary of care
visits. It is essential to educate patients of their rights under HIPAA to their
medical records to encourage secure download and transmission of online medical
records when needed by a third party. The ease of use of online medical records
is key to the overall perception of the usefulness of this platform, and
studies show that individuals believe online medical records are useful in
monitoring their health.
Twitter: @davo2short
LinkedIn: https://www.linkedin.com/in/2baba
Email the writer: davotushort@gmail.com
Comments
Post a Comment