Technology has been changing rapidly and redefining almost all sectors of life, and healthcare is not an exception. Patient portals through which they can access their electronic health records have helped improve efficiency and access to primary healthcare in a significant way. In days past, one's health information remained private and inaccessible, known only to the caregivers. This alienated the patient from their wellness journey. However, with the advent and increasing adoption of electronic health records and patient portals, a lot has changed within healthcare and how care is currently offered.
Through portals, patients not only know about their conditions and progress but are also able to access several other services such as; direct messaging to their doctors via the portals, which has immense value addition in increasing access to healthcare and promoting patient participation in their wellness journeys. The patient portals are linked to a facilities' electronic health system; it thus gives the patient access to the information entered by the various health workers in the hospitals
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Alotaibi and Federico, in the paper, The Impact of Health Information Technology on Patient Safety , elaborates on the implications of the various electronic health record systems used within healthcare settings (2017). These systems are designed in such a manner that only authorized personnel can access the patient data ensuring no breach of patient data privacy and safety. The patient can see their laboratory results, interpretations of diagnostic tests as well as their ongoing medications, and scheduled visits. Through this access to information, patients can relate a lot more closely with their caregivers, ask questions, and monitor their progress. Newly diagnosed patients with surgical cases are eager to see their imaging results, and portals avail this to their access points such as computers.
In the paper, Patient Portals and Patient Engagement by Irizarry, Dabbs, & Curran they highlight the centrality of portals in increasing participation by patients in their health journeys (2015). This is central in the management of chronic and debilitating illnesses such as lupus that require constant interaction with the health worker. The patient's awareness of their disease becomes a critical tool in encouraging them to a culture of reading and investing their time to know more about their condition. It also helps build a baseline understanding, which eases clinical education that caregivers have to impart (Irizarry, Dabbs, & Curran, 2015). Patients who have had prior access to their laboratory reports or diagnostic tests via the portals, in most cases, tend to have either read or asked a little more about them. As such, they may present ideas and clues that the clinicians can build on and clarify as they walk their health journeys together.
However, there is no evidence that portals increase patient safety (Alotaibi & Federico, 2017). Portals grant access to patients who have no management rights, nor do they carry any procedures on themselves; they thus cannot in any way intervene and have to rely on the accuracy of the information fed into the electronic health system by the healthcare workers. In instances where there is an error of entry into the automated health system, the portal facilitates the implementation of that error. A wrong frequency of medication on the portal passes on to the patient as is. Equally, portals are susceptible to hacks and breaches by hackers and cybercriminals who can easily compromise patient data.
In a paper by Hoogenbosch et al. on the use and users of patient portals, they highlight the impact of portals on the management of chronic diseases (2018). The research was conducted on outpatients visiting a facility. Whereas by the requirement of Medicaid, each facility ought to provide the patient portal service, not all patients take up the service. A multiplicity of factors influences the refusal to take up the service. The signup process is lengthy and requires one to verify several details. The process is critical as it helps safeguard data and ensure access is only granted to authorized persons. Others are simply ignorant of the existence of these services, and it takes an aggressive hospital marketing team to bring them on board. Nevertheless, from the study, several groups came across as critical users of this technology.
The classification of the users was based on disease condition, hospital department visited, and their general satisfaction with the hospital facilities. The literacy, as well as the disease awareness of the patients, were also checked. Most users of this technology were generally young patients, indicating that familiarity with technology plays a vital part in its adoption among different groups of people. The chronically ill were also notably significant. Based on the study, possible predictors of the use of a patient portal include; the presence of a chronic condition, high literacy, and longer travel hours to a facility. These then imply that the impact of patient portals is significant for people with chronic conditions, especially those that are required to travel far to get to a facility as well as the literate ones who quickly imbibe new information.
Ultimately, those using the technology are generally more aware of their illnesses and can confidently articulate what their problem is and where they are on their wellness journey (Hoogenbosch et al., 2018). Fundamentally, diabetic and hypertensive patients with regular clinic visits reap tremendous benefits from the portals
Older adults have a difficult time using patient portals. The few that use the gateways appreciate the ease with which they help them make healthy decisions. They also understand the ease and accessibility of their healthcare providers through the portal. This assertion is drawn from data obtained from an observational study on patient portal utilization among ethnically diverse low-income adults, by Arcury et al. (2017). The provision of training for older adults is necessary for them to reap in the benefits that the technology affords. The training should be offered to both the patient, the spouses, and caregivers in a bid to provide adequate reception and reinforcement to achieve the envisioned outcomes. A key difference observed in the study is the variations in the features offered on the portals of urban hospitals compared with those in rural settings. The study further noted that the adoption was lower in the country setups. This implies that the possible positive outcomes were inaccessible by the rural populace (Arcury et al., 2017).
Miotto, Kidd, and Dudley, in their paper, highlight the importance of electronic health records (EHRs) in research and prediction of the future of patients (2016). Electronic health records are the branches from which patient portals sprout. An electronic health record involves the entry of patient data in such a manner that supports the ease in retrieval, storage, and mass analysis through coded systems. Electronic health records are entered in such a way that they adhere to specific data dictionary standards. There is, therefore, a certain level of similarity and uniformity in the nature and entry format of data across facilities. A vital advantage of the EHRs is the ease of analyzing and researching in healthcare. While this is a secondary use of the records, it has improved and impacted patient care immensely (Miotto, Kidd, & Dudley, 2016).
Research is faster, and clinicians can make decisions with ease by considering similar, easily accessible patient records. Bulk data from select patients can easily be available through a simple click. Medical research, mainly retrospective studies, took tedious browsing of files. This lengthy bulky process made it difficult to verify the efficacy of certain practices within the field quickly, but EHRs have changed that. Machine learning, as well as other technological concepts, can be used in the patient records to draw insights and patterns of diseases and patients that influence research and health policies (Miotto, Kidd, & Dudley 2016).
The impact of electronic health records and patient portals on health outcomes on the patient level and macro level is very significant. Nonetheless, there needs to be a continuous strategic process to help advance the uptake as well as utilization of these technologies among all necessary quotas to diversify and enlarge the impact.
References
Hoogenbosch, B., Postma, J., Janneke, M., Tiemessen, N. A., van Delden, J. J., & van Os-Medendorp, H. (2018). Use and the users of a patient portal: Cross-sectional study. Journal of Medical Internet Research , 20 (9), e262. DOI: 10.2196/jmir.9418
Alotaibi, Y. K. & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal , 38 (12), 1173. DOI: 10.15537/smj.2017.12.20631
Miotto, R., Li, L., Kidd, B. A., & Dudley, J. T. (2016). Deep patient: an unsupervised representation to predict the future of patients from the electronic health records. Scientific Reports , 6 , 26094. https://doi.org/10.1038/srep26094
Irizarry, T., Dabbs, A. D., & Curran, C. R. (2015). Patient portals and patient engagement: a state of the science review. Journal of Medical Internet Research , 17 (6), e148. DOI: 10.2196/jmir.4255
Arcury, T. A., Quandt, S. A., Sandberg, J. C., Miller Jr, D. P., Latulipe, C., Leng, X., ... & Bertoni, A. G. (2017). Patient portal utilization among ethnically diverse low income older adults: observational study. JMIR Medical Informatics , 5 (4), e47. DOI: 10.2196/medinform.8026
