Personal Health Records

Information Systems in Health Care: Personal Health Records
Introduction
Information systems in health care are critical to processing and storing data related to patients and patient services, which in turn ensures that safe, quality care is provided to every patient (Heeks, 2006). One area that needs focus among health care providers is the area of the personal health record (PHR), as Kahn, Aulakh and Bosworth (2009) point out: a gap exists between what patients receive in terms of their personal health information and what they expect and want. The ideal personal health record is one in which the digital application is easily used by patients to help them manage and maintain their health information in an accurate, secure, private and effective way. (Health IT, 2013). The PHR should be managed by patients so that they can store data from multiple sources, such as their health care providers or themselves; it allows them to monitor their diet or exercise plans, see their medication lists, their treatment history, and so on. It is not a legal record to be used by a health care provider but is instead wholly for the patient’s own use so that the patient can be more informed about his or her own treatment. The purpose of the PHR is to enable the patient to be more included in his or her own treatment plan and care service so that whatever intervention is recommended is one that the patient can take ownership of. This paper will discuss PHRs and show how they can be applied in my nursing practice to enhance quality care for patients; it will also describe my own personal experience with PHRs and why I believe patients can benefit from their usage.
Why PHRs are Necessary
As the American Health Information Management Association (2017) points out, “Providing individuals with access to their health information is necessary in delivering high quality care” (p. 1) and PHRs are one way to help make that happen. The purpose of the PHR is to help health care providers to use the digital technology now available thanks to advancements in electronic technology in the Digital Age and apply those advancements to client services. PHRs allow patients to stay informed about their own treatment care and to be up to date on their own personal health information. By allowing them access to their own medical records through the PHR, providers give patients an opportunity to reduce costs associated with retrieving information through third parties. The problem, however, is that too few providers and patients are aware of the benefits of PHRs and do not take the time to use them or promote them. For health care providers, educating patients about how to use PHRs can save them both time and money by placing more ownership on staying informed about their own health on the patient (American Health Information Management Association, 2017). In other words, the PHR empowers the patient to stay focused on their own health instead of having to rely on the provider to conduct follow-ups or obtain information upon patient request. The PHR gives the patient the power to do that on their own.
Data Integrity, Ethics and Security
The PHR is also designed to be a safe and secure system in which the patient alone has access to the information provided. As Haes and Grembergen (2009) note, it is very important in today’s health care industry to be able to give patients an expert level of care in terms of data and personal information security—especially in today’s environment where websites and browsers collect data on users and sell it to third parties without the users’ knowledge. PHRs are meant to be private and are designed to maintain data integrity (meaning that no information is altered or changed by using the PHR—data stays true to what it was when compiled by the provider); and PHRs are designed to be secure so that patient information is not released to third parties. The ethical terms by which the PHR should be provided include the ability to secure the system so that it cannot be hacked, so that information cannot be lost or altered, and so that patients have access when they need it. The system is designed to be confidential and HIPAA law requires that patient information not be shared with anyone other than the patient without the patient’s consent. The PHR ensures the patient’s right to privacy by allowing the patient only to access the patient’s data through a special portal in the provider’s information system designed specifically for patient usage.
As Heeks (2006) notes, health information systems have shown that PHRs are a best practice option for providers who want to guarantee that patients are more involved in their own treatment plans and that their own health care awareness is at an optimal high: it supports the concept of preventive care and helps patients to stay connected to the guidance given by their providers. Kahn et al. (2009) show that personal health records need to be promoted more by providers as being safe, secure, private, and comprehensive, as the more that patients are aware of having this portal to their information that is safe and private, the more likely patients are to take more personal ownership of their own care. In short, the best practice evidence indicates that PHRs are an empowering tool for patients.
Personal Experience
One example of the PHR is the tethered or connected PHR, which links the patient portal directly to the health care provider’s electronic health records (EHR) system. This type of PHR allows the patient to securely log in to the provider’s EHR database to access his or her own personal health care records, to see lab results or to check for when a screening is scheduled. This type of PHR can be found at facilities that have designed a PHR system to connect to the EHR system at the facility in a safe and secure manner (Khan et al., 2009).
In my own personal experience, I have used the PHR when obtaining personal health care for myself. I found it to be very time efficient and helpful for giving me peace of mind about what was going on behind the scenes with lab tests. I could check my personal health records using the tethered PHR system at the facility where I received care and see the updates of my results without having to wait anxiously by the phone for a call from my provider. I felt connected and liberated in a way because I had secure access to my own information and was not dependent upon someone else to find the time to call me about my results. My positive experience gave me the motivation to recommend it to others in my family and among my friends so that they could stop worrying and/or wondering about when their test results would come in. Using the tethered PHR system, they could log in and see for themselves and also review their own medical history. Having this access gave them a peace of mind, just like it did for me, because it allowed them to see that the provider had their information all on hand and would make have everything they needed when considering a treatment plan.
Conclusion
The PHR is a personal health record that can be used by the patient to access his or her own medical records. In a tethered PHR, the patient’s portal provides secure entry into the provider’s EHR database so that the patients can see their own information, check up on lab reports, or get reminders on screening schedules and so on. It is a way for the patient to stay abreast of information regarding their own health and it allows patients to look up this information on their own without having to call into the facility, be put on hold, find the right person to talk to, or wait for a provider to call back with results from a lab. The PHR empowers the patient to take ownership of their health care and to stay informed and in the loop on their own treatment plan.
The PHR can help close the gap between patients and providers that exists as a result of a lack of communication and it can enhance quality care by ensuring that patients have all the information they need. It provides peace of mind for patients, as my own experience has shown, because it allows the patient to see all the data that the medical providers have in their own records. When patients are worried that their providers do not have all the necessary information, they can develop anxiety, but the PHR allows those fears to be put to rest.
This information has given me insight into my own nursing care practice and has inspired me to want to promote the use of PHR among patients and providers alike so that both know the benefits of this important health records system. Information sharing is one of the biggest and most popular innovations to emerge in the Digital Age. Technology has made it possible for people to communicate and share important data, and security in data sharing systems has improved so that personal information is protected and is only shared privately between the provider and the patient. This type of system is very helpful for patients who are coming of age in the Digital Era as this is the type of access that they expect because it is consistent with their own experiences using digital information sharing tools. I would recommend PHRs be implemented in all health care facilities as a result of this study and my own experience.

References
American Health Information Management Association. (2017). Analyzing Patient
Access to Personal Health Information. Retrieved from http://www.ahima.org/searchresults?q=personal%20health%20records
Haes, S. & Grembergen, W. (2009). Exploratory study in IT governance
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Health IT. (2013). What is a personal health record? Retrieved from
https://www.healthit.gov/providers-professionals/faqs/what-personal-health-record
Heeks, R. (2006). Health information systems: Failure, success and
improvisation. International Journal of Medical Informatics, 75(2), 125-137.
Kahn, J. S., Aulakh, V., & Bosworth, A. (2009). What it takes: characteristics of the ideal
personal health record. Health Affairs, 28(2), 369-376.