Health Information Technology (HIT) plays a critical role in leveraging health outcomes and improving care quality. More importantly, it positively impacts the patients' healthcare experience. The advent of technology has provided patients with a host of HIT platforms to monitor and manage their healthcare. The common examples of technological provisions that exist include the patient portal, healthcare application, and home monitoring device. All these technologies form a critical part of telehealth and telemedicine. Practitioners can remotely communicate and assess the patient hence improving accessibility. Nurses have an important role in the application of technology to manage patient data. Family Nurse Practitioners (FNP) have an opportunity to track a patient's history, progress, medications, and laboratory outcomes. The discussion's focus will be on creating a clinical case example of a patient who does not currently use any form of technology to access or manage health care data. Attention will be placed on how an FNP can utilize a patient portal to manage and access healthcare data amidst the existing challenges.
Clinical Case Example
Anna is a 33-year-old patient living in rural parts of Delaware. She has been battling respiratory and chest problems for the last six months. She was recently referred to Delaware Hospital for the Chronically Ill after failed attempts to manage her situation in the local clinics. After admission, it emerged that Anna has no medical records or an online portal where her treatment progress can be tracked. On asking, she revealed that most of her health records existed in "many pieces of paper," which she cannot track. Therefore, the hospital enrolled her as a new patient and started a new treatment model regardless of the medication or procedures used before. The hospital created a new portal for Anna, where she could log in from her computer or phone. The portal was synchronized to the hospital's Electronic Health System (EHS).
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Patient Portal
The advent of electronic medical records (EMR) provides patients with a chance to access their clinical data and actively participate in the care delivery process. The role of patient portals in this regard cannot be underestimated. As illustrated by Dendere, Slade, Burton-Jones, Sullivan, Staib, & Janda (2019), "Hospitals and other health care organizations can facilitate patient access to their EMR information through patient portals." According to the authors, patient portals have a vital role in securing patient information and providing online access to personal health information (PHI). Examples of information included in the portal include admission information, discharge information, immunizations, medication list, and laboratory outcomes (Dendere et al., 2019). Furthermore, the portals allow for secured information between the patient and the provider. The portals, therefore, improve the engagement between the hospital and the patient. Dendere et al. (2019) assert that improving patient involvement in the delivery of care directly contributes to the safety and quality of care.
Initially, Anna's PHIs were written on pieces of paper. She could not effectively file this information to assist in the continuity of care. Most importantly, there was no way to engage with care personnel constantly. Therefore, this jeopardizes not only continuity but also the overall quality of the care process. Also, it makes healthcare expensive as processes and procedures have to be repeated due to lack of or inadequate evidence. Research has further illustrated that the patient portal is vital in self-management and care coordination. The portals are particularly crucial in patients with known chronic illnesses (Sorondo et al., 2016). Patients using patient portals are likely to report improved experienced due to the increased engagement with their healthcare providers. Also, the need to report to the healthcare facility is reduced as patients can actively engage with their care providers. Anna, for instance, will receive instructions and updates regarding her health from the portal. Through self-management, the portal will have achieved health promotion by empowering patients to make evidence-based decisions. Patients using this platform have 24-hour access to their PHI from any location so long as they have a stable internet connection. Anna will only be required to master the secure username and password. As described by Sorondo et al. (2016), the portals are protected and therefore comply with the requirements of the health insurance and accountability act (HIPAA).
Barriers and Challenges
Like any other technology, an FNP must expect several challenges when applying this technology. The success of using this technology depends on a patient's health literacy. Health literacy refers to one's ability to obtain, interpret, understand, and apply health information to make sound decisions (Sorondo et al., 2016). One of the primary roles of the patient portal is to communicate with the provider and leverage self-management. However, this is impossible if the patient lacks the required health literacy. The second barrier regards logistics required to use the patient portals. According to Kooij, Groen and van Harten (2018), the implementation of patient portals is a complex and sophisticated process. The logistics challenge on the part of the patient remains a significant area of consideration. For patients to access their information, they need a functional phone or laptop and must have internet data. Therefore, patients in rural areas or from low socioeconomic families can face immense challenges. Thirdly, the usability difficult might bar the patient from navigating or using the portal altogether. The patient's lack of meaningful use could lead to deteriorated patient quality (Kooij et al., 2018). Therefore, patient negligence is a serious problem that could affect an FNP's successful use of the portals.
Solutions
Despite the barriers, FNPs can mitigate them using several strategies. The first step in finding a solution is through patient education. Patients must be informed and trained on the importance and use of the portals. The portals are complex spaces on the internet whose navigability can present challenges to health illiterate patients. Therefore, building the patient's capacity should be the priority for FNP's in their quest for success (Sorondo et al., 2016). The second solution must focus on the development of portals. User-friendliness must be an area of immense consideration. The developers of the portal must ensure that they are user-friendly and easy to navigate. Complex structures and systems within the portals will contribute to the negligence identified in the challenges section. Lastly, the FPN must continuously emphasize the portals' value and work together with the patients to achieve the desired success.
Conclusion
Patient portals directly contribute to the quality of care and encourage engagement between the patient and the care provider. They include a host of services and provisions that allow patients to securely access their PHIs and communicate with the nurses and other healthcare providers. Hospitals and the healthcare system, in general, must improve the use of these portals as a strategy for self-management and the improvement of care coordination. However, several barriers exist that FPNs must consider while using these technologies. The main ones include health illiteracy, lack of logistics such as internet access, and negligence. The barriers can be mitigated by organizing a training and capacity building session with the patient. The developers of the systems must create a user-friendly environment that enhances usability. Lastly, FPNs must work closely with patients to ensure that they maximize the importance of these portals.
References
Dendere, R., Slade, C., Burton-Jones, A., Sullivan, C., Staib, A., & Janda, M. (2019). Patient portals facilitating engagement with inpatient electronic medical records: A systematic review. Journal of Medical Internet Research , 21 (4), e12779.
Kooij, L., Groen, W. G., & van Harten, W. H. (2018). Barriers and Facilitators Affecting Patient Portal Implementation from an Organizational Perspective: Qualitative Study. Journal of Medical Internet Research , 20 (5), e183.
Sorondo, B., Allen, A., Fathima, S., Bayleran, J., & Sabbagh, I. (2016). A patient portal is a tool for enhancing the patient experience and improving the quality of care in primary care practices. Egems , 4 (1).
