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 concern. The office staff discussed that she had gone to receive part of her lab work 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 this process?

What are challenges for patients that do not have access to all of the EHRs? Remember, only portions of the EHRs are typically included in the PHRs. Please do not copy and paste also please reference information. Thank you

Answer 1

Answer 1: The pros and cons of the situation are:

• The patient is informed about her disease condition at the primary care physician's office.
• The use of EMR helps easy accessibility to her health record even from her home.
• This allows to share the custodianship of the information between health professionals.
• The patient may not be satisfied with their services as all her informations are not accessible to her.
• She may doubt her diagnosis as all the test results are not yet completed.
• Lack of staff who will be answerable to the concerns of the patient in the absence of a concerned person.

Answer 2: In order to ensure the safety of patient portals, the accessibility of portals are limited to patient and health professionals. Every patient portal is secured with a user name and a password know to patient and authorized personnels only. If an unauthorized personnel tries to gain access to a patient portal, its send a notification either through text or email to alert the patient and the hospital authority.

Answer 3: The use of patient portal for storing the patient health information is good but the information pertaining to patient must be integrated together. After the result of all test conducted whether within or outside the organization is completed, the diagnosis should be disclosed by the physician to the patient. This will prevent the unwanted stress and anxiety among patients.

Answer 4: A PHR does not contain all the details of the patient health information as recorded in EHR. The challenges for patients that do not have access to all of the EHR are:

• The patient who is a new user may not be aware of this fact of the system. This may develop concerns and bias regarding incomplete patient health information.
• Patient may doubt the efficacy of the organization stating inaccurate documentation.
• Patients will remain dependent on physician for narration of health information.
• Lack of access to complete health information will create difficulty in taking a second opinion from other health care institution.
• The patients may not be adherent to their care providers.

Refernces:

1. Beard, L., Schein, R., Morra,D., Wilson, K.,& Keelan, J. (2012). The challenges in making electronic health records accessible to patients. Journal of the American Medical Informatics Association: JAMIA, 19(1), 116-120.