Provide resources on how to access and use health information so that patients and caregivers understand how to use their data safely, securely, and effectively.

Personal Health Records and Patient Portals

INTRODUCTION
The Federal Health information technology (IT) Strategic Plan 2020–2025 final report had a clear message for patients and providers that access to health data by the patient is key (Office of the National Coordinator for Health Information Technology [ONC], 2020). This strategy is an evolution of the 2015 efforts to “collect data, share data and use data” (ONC, 2014, p. 5). The strategies set forth by the latest plan are as follows (ONC, 2020, pp. 21–22):
■ Enable individuals to access their health information by ensuring that they are able to view and interact with their data via secure mobile apps, patient portals, and other tools.
■ Promote greater portability of health information through application program interfaces (APIs) and other interoperable health IT permits individuals to readily send and receive their data across various platforms.
■ Improve access to smartphones and other technologies needed to attain and use health information, especially for at-risk, minority, rural, disabled, and tribal populations.
■ Build the evidence base on the use of health information, including the types of information that will benefit individuals most and the best way to present information to patients and caregivers.
■ Provide resources on how to access and use health information so that patients and caregivers understand how to use their data safely, securely, and effectively.

The use of EHRs has risen dramatically in recent years in private practice. According to a National Electronic Health Records survey in 2017 with the National Center for Health Statistics, the amount of office-base providers using a certified electronic health record (EHR) technology (CEHRT) system in the United States was almost 86%, and using a certified EHR was almost 80% (Myrick et al., 2019). Important to this growth is the PHR, a component associated with the EHR that provides specific access via an electronic portal for the patient’s view of their information. A PHR is defined by the Social Security Act (42 USC 1320d[6]) as including “individually identifiable health information that includes, with respect to an individual, information:
(A) that is provided by or on behalf of the individual; and
(B) that identifies the individual, or with respect to which there is a reasonable basis to believe that the information can be used to identify the individual”

(see Congressional Record—House, February 12, 2009, p. H1348, which is available online at www.ssa.gov/OP_Home/ssact/title11/1171.htm).

The National Learning Consortium indicated that a patient portal, on which a PHR exists, is a “secure online website that gives patients convenient 24-hour access to personal health information from anywhere with an Internet connection” (HealthIT.gov National Learning Consortium, 2014, p. 1). Using a secure username and password, patients can view health information, such as the following:
■ Summarized health profile (e.g., most recent vital signs or weight)
■ Recent provider visits and notes
■ Discharge summaries
■ Medications
■ Immunizations
■ Allergies
■ Lab results, pathology reports
■ Radiology results
■ Procedure history
■ Trackers (e.g., patient can self-report weight, steps, blood pressure, blood glucose)
Some patient portals also allow patients to do the following:
■ Exchange secure emails with their healthcare teams
■ Request prescription refills
■ Schedule non-urgent appointments
■ Check benefits and coverage
■ Update contact information
■ Make payments
■ Download and complete forms
■ Pre-register for visits
■ Send images such as photos of rashes and wounds
■ Input patient-generated health data (PGHD) such as histories, allergies, medications
■ View educational materials (ONC, 2017, p. 1)

With patient portal implementation, an organization can enhance patient–provider communication, empower patients, support care between visits, and, most important, improve patient outcomes (HealthIT.gov National Learning Consortium, 2014, p. 1). As illustrated in Figure 15.1, the components of the PHR/patient portal typically include
(a) patient records/history (from the provider’s main EHR); (b) educational/training documents; (c) collaboration methods, such as email 24 hours a day, to communicate with healthcare professionals; and (d) quality metrics, such as outcome measures, that demonstrate progress over time (Cognator.com, 2014).

Regarding efficiencies, the portal provides a means for the provider to send messages to the patient and ease workflow by reducing phone messages and unscheduled visits by the patient (Clarke et al., 2013). Patients benefit from portal use, as they are allowed to use the services provided rather than waiting for long periods for phone calls to be returned by the clinic. Portal use may also be cost-effective in that it may decrease the need for repeated tests and procedures by specialists or emergency care providers, as the patient has the ability to access diagnostic procedures and interventions from a laptop, computer, tablet, or smartphone (Di Maio, 2010).