The Future of Personal Health Records and Patient Portals
Main Article Content
Abstract
Over the last two decades, the early development of standalone Personal Health Records (PHRs), and later tethered patient portals, have had a transformative effect on engaging patients by providing them with tools to manage their health and unprecedented access to their heath data. However, despite anticipated benefits and continued high consumer demand for online access to personal health information, adoption and sustained use has been less than expected. Moreover, powerful forces are transforming healthcare, necessitating change and adaptation.
This aim of this paper is to examine several significant trends that are influencing the intersection of health care and technology and provide an assessment of the impact of these trends on the future of PHRs and patient portals. An aging population with an increased prevalence of chronic disease and mental health conditions, coupled with rising consumerism and more diverse care settings, has significant implications for patient-facing tools such as patient portals. Similarly, the proliferation of data generating consumer health technology and technical advances such as artificial intelligence and emerging data standards calls for the next iteration of tools to support care delivery. Moreover, the acceleration of virtual care driven by national policy changes and the COVID 19 pandemic requires better tools to realize the promising potential of the technology in an increasingly complex and interconnected world.
Taken together, these factors may provide the perfect storm that will enable a critical shift to envision a more holistic patient-centric information and resource hub that is characterized by improved architecture, optimized design and content, a robust set of well-designed tools and functions, and enhanced integration with clinical care processes and structures. This personal health portal could provide a long desired single comprehensive longitudinal personal health record with best of breed design and features to empower patients as they navigate their health journey.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. What is a personal health record? United States Office of the National Coordinator Web site: HealthIT.gov. https://www.healthit.gov/faq/what-personal-health-record. Last updated May 02, 2016. Accessed November 15, 2021.
3. My HealtheVet. Department of Veterans Affairs Web site. https://www.myhealth.va.gov. Accessed November 15, 2021.
4. Moscovitch B. Americans Want Federal Government to Make Sharing Electronic Health Data Easier. PEW. https://www.pewtrusts.org/en/research-and-analysis/articles/2020/09/16/americans-want-federal-government-to-make-sharing-electronic-health-data-easier. Published September 26, 2020. Accessed November 15, 2021.
5. Promoting Interoperability Programs. Centers for Medicare & Medicaid Services. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms. Last updated November 29, 2021. Accessed November 30, 2021.
6. Anthony DL, Campos-Castillo C, Lim PS. Who isn’t using patient portals and why? Evidence and implications from a national sample of US adults. Health Aff (Millwood) 2018; 3712: 1948–54.
7. Ernst & Young. Megatrends 2015: Making sense of a world in motion. Published 2015.
8. Ernest & Young. Megatrends shaping 2018 and beyond: what’s after what’s next. https://assets.ey.com/content/dam/ey-sites/ey-com/en_gl/topics/disruption/ey-megatrends-final-onscreen.pdf. Published 2018. Accessed November 15, 2021.
9. Frist WH. Connected health and the rise of the patient-consumer. Health Aff. 2014;33(2). https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2013.1464. Published February 2014. Accessed November 15, 2021.
10. National Institute of Mental Health. Statistics. https://www.nimh.nih.gov/health/statistics/mental-illness.shtml#part_154785. Published 2019. Accessed November 15, 2021.
11. Substance abuse and Mental Health Services Administration. Results from the 2014 national survey on drug use and health: mental health findings. http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf. Published 2015. Accessed November 15, 2021.
12. Etingen B, Hogan TP, Martinez RN, et al. How do patients with mental health diagnoses use online patient portals? An observational analysis from the Veterans Health Administration. Adm Policy Ment Heal Ment Heal Serv Res. 2019;46(5). doi:10.1007/s10488-019-00938-x. Accessed November 15, 2021.
13. Harris M. Digital Arts: How to design for people struggling with mental health. https://www.digitalartsonline.co.uk/features/interactive-design/how-design-for-people-struggling-with-mental-health/. Published December 05, 2017. Accessed November 15, 2021.
14. Rotondi AJ, Eack SM, Hanusa BH, Spring MB, Haas GL. Critical design elements of e-health applications for users with severe mental illness: singular focus, simple architecture, prominent contents, explicit navigation, and inclusive hyperlinks. Schizophr Bull. 2015;41(2), 440–448. doi:10.1093/schbul/sbt194. Accessed November 15, 2021.
15. Sharit J, Lisigurski M, Andrade A, et al. The roles of health literacy, numeracy, and graph literacy on the usability of the VA’s personal health record by veterans. J Usability Stud. 2014;9(4), 173-93.
16. McInnes DK, Solomon JL, Shimada SL, et al. Development and evaluation of an internet and personal health record training program for low-income patients with HIV or hepatitis C. Med Care. 2013;51(3 SUPPL. 1). doi:10.1097/MLR.0b013e31827808bf.
17. Watson Z. HISTalk: Do third-party patient portals offer any advantages over vendor-specific options? http://www.histalkpractice.com/2015/01/14/do-third-party-patient-portals-offer-any-advantages-over-vendor-specific-options/. Published January 14, 2015. Accessed November 15, 2021.
18. United States Congress. VA MISSION Act of 2018. https://www.congress.gov/115/bills/s2372/BILLS-115s2372enr.pdf. Published 2018. Accessed November 15, 2021.
19. Pratt M. The future of patient portals. Medical Economics. 2018;95(13). https://www.medicaleconomics.com/business/future-patient-portals. Accessed November 15, 2021.
20. Cortez A, Hsii O, Mitchell E, Riehl V, Smith P. Conceptualizing a data infrastructure for the capture, use, and sharing of patient-generated health data in care delivery and research through 2024. https://www.healthit.gov/sites/default/files/onc_pghd_final_white_paper.pdf Published January 2018. Accessed November 15, 2021.
21. United States Congress. 21st Century Cures Act. https://www.congress.gov/bill/114th-congress/house-bill/34. Published December 13, 2016. Accessed November 15, 2021.
22. Centers for Medicare & Medicaid Services. Proposed Rule 84 FR 7610. Interoperability and patient access for MA Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, Issuers of QHPs in the federally-facilitated exchanges and health care providers. https://www.federalregister.gov/documents/2019/03/04/2019-02200/medicare-and-medicaid-programs-patient-protection-and-affordable-care-act-interoperability-and. Published March 04, 2019. Accessed November 15, 2021.
23. Centers for Medicare & Medicaid Services. Proposed Rule 83 FR 35704. Medicare Program; revisions to payment policies under the Physician Fee Schedule and other revisions to Part B for CY 2019; Medicare Shared Savings Program requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program (CMS-1693-P). https://www.federalregister.gov/documents/2018/07/27/2018-14985/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions. Published July 27, 2018. Accessed November 15, 2021.
24. Lactman, N. 2018. FAQs: everything you need to know about chronic care remote physiologic monitoring codes. [Blog] Health Care Law Today. https://www.healthcarelawtoday.com/2018/11/02/medicare-remote-patient-monitoring-reimbursement-faqs-everything-you-need-to-know-about-chronic-care-remote-physiologic-monitoring-codes/. Accessed November 15, 2021.
Wosik J, Fudim M, Cameron B, et al. Telehealth transformation: COVID-19 and the rise of virtual care. J Am Med Informatics Assoc. 2020;27(6). Accessed November 15, 2021.
Landgraf C. 3 ways artificial intelligence will improve healthcare in 2019. HIT Consultant. https://hitconsultant.net/2019/01/09/3-ways-artificial-intelligence-improve-healthcare-in-2019/#.XR9SLvZFw2w. Published January 9, 2019. Accessed November 15, 2021.
European Lung Foundation. AI improves doctors' ability to correctly interpret tests and diagnose lung disease. ScienceDaily. https://www.sciencedaily.com/releases/2018/09/180918180501.htm. Published September 18, 2018. Accessed November 15, 2021.
25. HIPAA Journal. Analysis of 2018 healthcare data breaches. https://www.hipaajournal.com/analysis-of-healthcare-data-breaches/. Published January 28, 2019. Accessed November 15, 2021.
26. Van Wagenan J. 4 important items on your 2019 HIPAA compliance checklist. Health Tech Magazine. https://healthtechmagazine.net/article/2019/02/4-important-items-your-2019-hipaa-compliance-checklist-perfcon. Published February 19, 2019. Accessed November 15, 2021.
27. Gatto J. How blockchain can improve healthcare. https://www.lawoftheledger.com/2018/03/articles/blockchain/how-blockchain-can-impact-healthcare/. Published March 1, 2018. Accessed November 15, 2021.
Pew Research Center. Mobile Fact Sheet. https://www.pewinternet.org/fact-sheet/mobile/. Published April 7, 2021. Accessed November 15, 2021.