NURS 8210 Personal Health Records

The mandating of FHRs is a controversial subject. NURS 8210 Personal Health Records. There are many patients who are very amenable to mandating these, as they like to feel that they are in control of their health care and want to feel as though they are working as a team with their health care providers. However, there are several issues with EHRs that may be an obstacle to patients. Some noted accessibility challenges are portals that feature small-font, English-only, text-based content that is written at a very high literacy level. In addition, existing portals often employ user interfaces that are complex to navigate and difficult to customize (Lyles et al., 2017). Both the portals provided in the discussion were a bit hard to navigate and became somewhat unwieldy.  The portal must be made accessible to all patients in an equitable manner that can be understood.

Lyles et al. (2017) argue that a growing amount of literature documents that certain patient subgroups (such as racial/ethnic minority groups and those with lower socioeconomic status) are significantly less likely to use portals—despite strong interest in portal functionality as well as high Internet and computer use rates across demographic groups in the United States. Paradoxically, these patient subgroups represent populations with disproportionately greater medical needs. Much of the literature points to factors such as socioeconomic group, literacy, and ethnicity having the most influence on whether the patient can be induced to use a patient portal.  Izarry et al. (2015) conclude that current research has demonstrated that patients’ interest and ability to use patient portals are strongly influenced by personal factors such as age, ethnicity, education level, health literacy, health status, and role as a caregiver. Indeed, if a patient is disabled, caring for an elder or a child, access to a patient portal is essential for them. If a patient perceives that their provider endorses the use of a portal and encourages them in a positive way, they might be amicable to adopt the use of one. Conversely, if the provider is indifferent or disinterested, the patient may be hesitant to adopt the use of EHRs.

 

 

 

 

As with anything that is digital, there is always a chance of a cyberattack that can lead to a breach of the portal and the potential exposure of private information. According to the National Law Review (2019), around 25 million patient records have been breached, eclipsing the number of patient records breached in all of 2018 by over 66%. Healthcare providers and organizations can enhance the security of a patient portal by enhancing the sign-in process. Instead of the traditional username-password entry, a 2-factor authentication or an authentication sent through a mobile device may add an extra layer of protection. Healthcare organizations are not required to adopt any one cybersecurity framework or authentication method under HIPAA, however increasing cybersecurity and implementing multi-factor authentication for access to patient portals certainly helps with compliance under the HIPAA Security Rule (National Law Review, 2019).  If robust cybersecurity methods are not implemented, a security breach and leak of private information can embroil a healthcare organization in many legal tangles that could be avoided with a sound, up-to-date cybersecurity system. The portals explored here in the discussion both do not use 2-factor authentication.

Patient portals when used are invaluable to both the provider and the patient. When the patient feels they are included and are collaborative with their care, the interactions between provider and patient tend to be more positive. Envisioning the patient portal as a dynamic component of the relationship that a provider has with patients can better help to integrate the patient portal into the practice as a whole. This is infinitely better than seeing this as a separate and isolated abyss of information that is not helpful or useful. The value of a patient’s medical information is not only for the provider and patient but can encompass and facilitate research in addition.

References:

Bertoncini, M., Jackson, V. (2019). Is your patient portal secure? Study shows healthcare organizations’ traditional cybersecurity measures are insufficient against today’s attacks. National Law Review, Volume IX, Number 212

Irizarry, T., DeVito Dabbs, A., & Curran, C. R. (2015). Patient Portals and Patient Engagement: A State of the Science Review. Journal of medical Internet research, 17(6), e148.

Lyles, C. R., Fruchterman, J., Youdelman, M., & Schillinger, D. (2017). Legal, Practical, and Ethical Considerations for Making Online Patient Portals Accessible for All. American Journal of public health, 107(10), 1608–1611.

In daily practice, healthcare professionals collect volumes of patient data that vary in type and sensitivity, among other defining elements. As technology use intensifies in health care delivery, electronic health records (EHRs)/electronic medical records (EMRs) have increasingly become a vital component for data storage, retrieval, and sharing. The shift from paper-based to electronic formats has transformed nursing documentation significantly. This discussion explores how EHRs/EMRs have changed nursing documentation of patient care.

Transforming the Quality of Nursing Documentation

The quality of patient care is directly proportional to the quality of nursing documentation. Accordingly, the documentation process must be of high standards. After comparing the process and structure of paper-based health records and EHRs, the electronic formats have been found to have better content input, process, and structure (Akhu‐Zaheya et al., 2018). Here, the implication is that patient data can be stored, processed, and shared in different formats as situations necessitate. Electronic information is also more secure than paper-based records.

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EHRs and Facilitating Efficiency in Documentation

Time is a critical element in health care delivery whose wastage has far-reaching implications on a patient’s health. Generally, EHRs improve efficiency in nursing documentation by reducing the time and clicks used in making an entry. Karp et al. (2019) found that, compared to paper-based documentation, EHRs can reduce the time spent in documenting patients’ history by up to 72%. Essential items are also documented appropriately and timely as required. The enhanced efficiency improves clinical workflow proportionately.

Conclusion

Data is crucial in enhancing decision-making in health care and validating patient care documentation accurately, professionally, and conveniently. EHRs have transformed nursing documentation by improving the quality and efficiency of documentation. Nurses can also store and retrieve electronic patient data in multiple formats and when needed.

 

 

References

Akhu‐Zaheya, L., Al‐Maaitah, R., & Bany Hani, S. (2018). Quality of nursing documentation: Paper‐based health records versus electronic‐based health records. Journal of Clinical Nursing, 27(3-4), e578-e589. DOI: 10.1111/jocn.14097

Karp, E. L., Freeman, R., Simpson, K. N., & Simpson, A. N. (2019). Changes in efficiency and quality of nursing electronic health record documentation after implementation of an admission patient history essential data set. CIN: Computers, Informatics, Nursing, 37(5), 260-265. DOI: 10.1097/CIN.0000000000000516

Personal Health Records

Consider the PHRs of today. Patient-accessible health records are currently web-based and have seen little consumer use when compared to the total U.S. population. The VA has had notable success with its veterans logging on; however, other web-based portals have struggled. GoogleHealth, a free PHR site, shut its services down effective January of 2012 citing too few and inconsistent users to maintain the site.

PHRs can eliminate the plethora of patient charts and help to assimilate a lifetime of medical documentation. What do you think will motivate society to fully embrace these electronic resources?

To prepare:

• Reflect on the information presented in the Learning Resources, focusing on personal health records and patient portals as used by the VA.
• Consider your personal and professional experiences with personal health records and patient portals.
• What benefits, concerns, and challenges do these types of systems bring to the healthcare profession? How might they influence your professional practice and your patient’s health outcomes?
• Explore one patient portal. If you do not have access to one through your practice setting, utilize a free service such as FollowMyHealth or Microsoft HealthVault.
• Assess the kind of information that you would put in your own personal health record. What concerns (if any) would you have about the security of your personal information in a personal health record?
• Think about your stance on the value of PHRs. Do you believe that every individual should be required to maintain a PHR?
  • What capabilities and/or features might entice people to use them?
  • What factors might inhibit people from using them?

By Day 3 post a cohesive response that addresses the following:

• Appraise your selected personal health patient portal.
• Evaluate the influence of PHRs on health care delivery and clinical practice.
• Take a position for or against mandating PHRs. Justify your stance by addressing the following points:
  • Personal health records via patient portals are part of Meaningful Use 2 and the debate over mandating them is essentially over.
  • What capabilities and/or features might motivate individuals to maintain PHRs?
  • What factors may deter individuals from signing up for this service?
  • What concerns might you and your patients have about a PHR’s capability to securely maintain personal information?
  • How might PHRs influence your professional practice and your patient’s health outcomes, positively or negatively?

Read a selection of your colleagues’ postings.

By Day 6 respond to at least two of your colleagues in one or more of the following ways:

• Select a college whose views are in opposition to yours. Use your research to academically debate why your viewpoint differs from theirs.
• Ask a probing question, substantiated with additional background information, evidence, or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
• Validate an idea with your own experience and additional research.
• Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.