PHR and Web Portals Research Draft #2

I am continuing to pursue the advancement and adoption of standardized Personal Health Records (PHR) and web portals. While the idea of the PHR has been around for quite some time, and many hospitals and clinics across the nation now have them in some form, adoption among consumers has been mixed and likely far below where it should be. There are a number of individual portals for things such as finance, social media, academics, and shopping that have advanced and been adopted at a much greater pace than PHRs. Arguably, wide ranging and equitable access should be a hallmark of healthcare in the very near future.

There is a lot of research on this issue existing, and I have a couple of ideas regarding gathering primary data to investigate future adoption of PHRs. First, in order to gauge patient sentiment, I would like to conduct a primary survey of patients. By patients, I am planning on surveying a wide range of people, and not necessarily within the vicinity of a healthcare facility at the time of surveying, as most can be considered patients of the healthcare system at one point or another. I would like to include questions on this survey to gather interest in using a personal health record. Questions would gather data on if patients currently use a PHR through a care provider, if they would prefer a consolidated PHR or multiple portals, and how frequently they would access their PHR. I have included a sample list of questions at the end of this post, which I would appreciate feedback on prior to implementing and executing the actual survey.

From our Consumer Health Informatics textbook, there are a number of key points that should be included in a personal health record to make them useful to patients and widely adopted. These include portability, interoperability, patient control, secure access and data protection as well as auto-population. While the concept of a PHR is simple, they can be very complex, cloud based, physical copies, tethered to an EHR system, or even untethered. This means that even in this technical age there is alot of uncertainty around how things will look moving forward.

When it comes to a centralized portal for access to your PHR, there are a number of implications that should be noted. The first is that providing patient access to a wide-ranging personal health record provides one more area from which data can be compromised and exploited. Some patients may build accounts with weak levels of password protection for example, exposing their information to theft and compromise from malicious actors. Another concern is that if there was to be one centralized system online where PHRs were accessible, from hospitalizations to eye appointments, who would manage and develop the platform? Would it be a private entity that somehow was able to form partnerships and attain access to this data, or would the project be federally administered? Maybe a technology like block chain could be employed to ensure confidentiality of patient information. Additionally, some patients could possibly push back against having their information all located in one place, or in the possession of another group aside from their direct medical providers. Even if these issues were to be overcome, it is safe to assume that it would be a large capital expenditure to develop and coordinate such a strong system. There are a number of complications that could mean there are significant delays, or that it is never fully developed.

In the coming decade, or maybe just the coming years, I’d love to see a more comprehensive and accessible PHR portal be developed. Personally, I would use this information to check my immunization history, view transcripts from doctors’ appointments, and review my prescription history. Regardless of care provider or time, having all of this information quickly accessible in one place would be extraordinary for the average patient, let alone those who deal with chronic or terminal health conditions. Between now and then, I am hoping that through firsthand surveying I can gauge what patients are seeking and hoping for in this next wave of technology based healthcare advancement. If you have suggestions or ideas on what you’d like to see from my research, please let me know.

Anticipated Survey Questions:

Do you currently use one or more web portal for any doctor, hospital, or health provider that you visit?

Do you keep a personal record of your health via either your computer or a hard copy?

If a web based portal is available through your provider, would you sign up and access it at least every six months?

Would you pay any monetary value for access to such a system? If so, what is the maximum annual price you’d be willing to pay?

Would you prefer to access your PHR and web portal via desktop or mobile device more?

Do you expect the capability to directly contact physicians and care providers through a web based portal?

Would you enjoy if the portal sent your mobile device push notifications to alert you to upcoming appointments or soon to expire prescriptions?

Are you willing to pay higher health insurance premiums if the insurer centrally tracks and advocates to receive and store your personal health record?

References:
1. http://www.healthcareitnews.com/news/kaiser-phr-sees-4-million-sign-most-active-portal-date
2. http://www.medscape.com/viewarticle/883612

3. Consumer Health Informatics, Ch 10, by Robert Hoyt and Ann Yoshihashi