Electronic healthcare record; a way to empower the patient

Beun, Johan G.

doi:10.1016/s1386-5056(03)00060-1

Cited by 21 publications

(11 citation statements)

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“…Significant investments have been made by organizations to offer PHRs based on the desire to enhance patient-centered care [7-11], and the perceived potential for health care system improvement [12,13]. Historically, most PHR implementation efforts have focused on broad conceptions of consumer empowerment in which advocates emphasize the potential for PHRs to (1) increase consumer access to and control over health information, and (2) enable active patient participation in health care decision making and health management [14,15]. Despite high consumer interest in PHRs [16-21] and growing availability [22-25], a paradox exists in that adoption remains relatively low overall [26-28].…”

Section: Introductionmentioning

confidence: 99%

The Personal Health Record Paradox: Health Care Professionals’ Perspectives and the Information Ecology of Personal Health Record Systems in Organizational and Clinical Settings

Nazi¹

2013

J Med Internet Res

158

144

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BackgroundDespite significant consumer interest and anticipated benefits, overall adoption of personal health records (PHRs) remains relatively low. Understanding the consumer perspective is necessary, but insufficient by itself. Consumer PHR use also has broad implications for health care professionals and organizational delivery systems; however, these have received less attention. An exclusive focus on the PHR as a tool for consumer empowerment does not adequately take into account the social and organizational context of health care delivery, and the reciprocal nature of patient engagement.ObjectiveThe purpose of this study was to examine the experiences of physicians, nurses, and pharmacists at the Department of Veterans Affairs (VA) using an organizationally sponsored PHR to develop insights into the interaction of technology and processes of health care delivery. The conceptual framework for the study draws on an information ecology perspective, which recognizes that a vibrant dynamic exists among technologies, people, practices, and values, accounting for both the values and norms of the participants and the practices of the local setting. The study explores the experiences and perspectives of VA health care professionals related to patient use of the My HealtheVet PHR portal and secure messaging systems.MethodsIn-depth interviews were conducted with 30 VA health care professionals engaged in providing direct patient care who self-reported that they had experiences with at least 1 of 4 PHR features. Interviews were transcribed, coded, and analyzed to identify inductive themes. Organizational documents and artifacts were reviewed and analyzed to trace the trajectory of secure messaging implementation as part of the VA Patient Aligned Care Team (PACT) model.ResultsStudy findings revealed a variety of factors that have facilitated or inhibited PHR adoption, use, and endorsement of patient use by health care professionals. Health care professionals’ accounts and analysis of organizational documents revealed a multidimensional dynamic between the trajectory of secure messaging implementation and its impact on organizational actors and their use of technology, influencing workflow, practices, and the flow of information. In effect, secure messaging was the missing element of complex information ecology and its implementation acted as a catalyst for change. Secure messaging was found to have important consequences for access, communication, patient self-report, and patient/provider relationships.ConclusionsStudy findings have direct implications for the development and implementation of PHR systems to ensure adequate training and support for health care professionals, alignment with clinical workflow, and features that enable information sharing and communication. Study findings highlight the importance of clinician endorsement and engagement, and the need to further examine both intended and unintended consequences of use. This research provides an integral step toward better understanding the social and organi...

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Section: Introductionmentioning

confidence: 99%

The Personal Health Record Paradox: Health Care Professionals’ Perspectives and the Information Ecology of Personal Health Record Systems in Organizational and Clinical Settings

Nazi¹

2013

J Med Internet Res

158

144

View full text Add to dashboard Cite

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“…In order to guarantee a high level of quality with regard to the functions offered and the processes supported by EHRs, it seems Information offered should be accurate/unambiguous. [23,25,36,47,59,64,68,76,80,86,91,112] 3 N…”

Section: Discussionmentioning

confidence: 99%

“…[4,31,33,47,49,68,84,90,116] 1 N Information offered should be complete and comprehensive. [23,25,36,47,59,80,86,117] 2 N Metainformation should be available for data [83,102] including when care took place [38,59], the clinical setting [59] and the qualification of the author [38,54,[83][84]. [38,54,59,[83][84]102] 4 N…”

Section: Discussionmentioning

confidence: 99%

Electronic Health Records

Hoerbst

Ammenwerth²

2010

Methods Inf Med

157

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The manuscript gives comprehensive insight into the currently available, primarily non-functional, EHR requirements. To our knowledge, there are no other publications that have holistically reported on this topic. The requirements identified can be used in different ways, e.g. the conceptual design, the development of EHR systems, as a starting point for further refinement or as a basis for the development of specific sets of requirements.

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“…For example, a “Home Telecare System” that integrates clinical signs monitoring, automated scheduling, and medication reminders, access to health education, and daily logs, can help patients self‐manage their chronic disease 40 . There are also a number of examples of systems that facilitate patient‐EHR interactions and studies have shown a benefit to having patients view their medical data 40–42 …”

Section: Issues In It Implementationmentioning

confidence: 99%

Priorities and Strategies for the Implementation of Integrated Informatics and Communications Technology to Improve Evidence-Based Practice

Doebbeling

Chou

Tierney³

2006

J Gen Intern Med

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The U.S. health care system is one of the world's most advanced systems. Yet, the health care system suffers from unexplained practice variations, major gaps between evidence and practice, and suboptimal quality. Although information processing, communication, and management are key to health care delivery and considerable evidence links information/communication technology (IT) to improvements in patient safety and quality of care, the health care system has a longstanding gap in its investment. In the Crossing the Quality Chasm and Building a Better Delivery System reports, The Institute of Medicine and National Academy of Engineering identified IT integration as critical to improving health care delivery systems. This paper reviews the state of IT use in the U.S. health care system, its role in facilitating evidence-based practices, and identifies key attributes of an ideal IT infrastructure and issues surrounding IT implementation. We also examine structural, financial, policy-related, cultural, and organizational barriers to IT implementation for evidence-based practice and strategies to overcome them.

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Electronic healthcare record; a way to empower the patient

Cited by 21 publications

References 0 publications

The Personal Health Record Paradox: Health Care Professionals’ Perspectives and the Information Ecology of Personal Health Record Systems in Organizational and Clinical Settings

The Personal Health Record Paradox: Health Care Professionals’ Perspectives and the Information Ecology of Personal Health Record Systems in Organizational and Clinical Settings

Electronic Health Records

Priorities and Strategies for the Implementation of Integrated Informatics and Communications Technology to Improve Evidence-Based Practice

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