What Must Physicians and Patients Consider When Sharing Information on the Portal?
Doesn’t it seem faintly ridiculous that patients have to jump through hoops to get access to information that, since it is in digital format, would be so readily available to them? Today’s patients are quite accustomed to being able to access data on demand, from whatever location on Earth, as long as they have Internet access and a mobile device or laptop computer. They can, for example, log into their financial institution’s website to check their latest details. Parents of school-aged children routinely access a portal developed by their school to get information about upcoming tests, new requirements, and so on.
This is also at a time when consumerism and consumer orientation are increasing significantly. For most upper- and middle-income countries, on-line consumer access to information is readily available. Many citizens are fluent in on-line services such as retail purchasing and travel booking, and see this not just as time saving, but as a means of determining the specific service configuration of their choice. Such on-line services are increasingly sophisticated, for instance the civil aviation sector has progressed from simple on-line bookings to on-line check-in, seat selection, meal choice, and choice of additional services. In all these cases, the consumer accesses and manages his/her own data, even within a complex and safety critical corporate system. Similarly, in the health context, patient information needs should not be limited to obtaining general knowledge. There should be opportunity for patients to access their medical records and the content within them. Providing patients with access to personalized health information is believed to be a means of improving communication between patients and providers, contributing to more accurate information, and helping patients to prepare for upcoming clinical visits, and cope with the potential anxiety. This notion has been supported by evidence that shows that the failure to fully inform patients can lead to poor treatment adherence. Nevertheless, shared decision-making or patient-centred care is not practiced widely in many jurisdictions. According to Alston, part of the reason for this is the existence of major differences between what clinicians think patients should know, what patients want to know, what patients think they know, and what patients actually know. Inability to find or organise a common platform may have been a reason in the past, but due to technical advances as described from other sectors this no longer holds as a valid barrier.
Similarly, most providers did not know whether their patients used technology to find health information online. Data from our randomized trial suggest that 77% of patients search for health information online. Providers’ perceptions of patients’ online habits may influence whether that provider thinks the portal is useful for their patients. Factors that may influence how providers perceive their patients’ online habits include not only the patient’s age, but also his or her socioeconomic status, race, ethnicity, and preferred language. Future research should explore how these factors impact providers’ interactions with acute care portals and the patients who use them. Provider’s slight disagreement with the statement “the acute care patient portal makes it easier for my patients to contact me” highlights the challenge of integration with the EHR. In this case, patient-entered comments or pain levels from the portal may not have been easily accessible or obvious in the EHR (Collins SA, Vawdrey DK). Furthermore, none of the providers surveyed recalled any patients who reported inaccurate information in the portal. However, 24 (17%) portal users reported finding inaccurate information, and 7 (6%) reported that they communicated it to a provider. Both providers’ lack of recall and patients’ lack of communication highlight the need for better mechanisms that allow patients to report inaccurate information. For example, better visibility of patient-entered comments in the EHR may improve communication. Future research should explore strategies for patients to contribute to their health record and improve its quality (Bitton A, Poku M, 2015).
Thus, your information may also be shared electronically for other purposes such as payment, health care operations, educational or research purposes. In many cases, your approval is required before your health information is shared. At Michigan Medicine, we are committed to protecting the privacy of your health information. To learn more about how we use and disclose your health information and when your authorization is required for certain disclosures, read our Notice of Privacy Practices on the Protecting Your Privacy page. Also, you can learn more information from this video explaining health information sharing.
American Hospital Association. Individuals’ Ability to Electronically Access Their Hospital Medical Records, Perform Key Tasks is Growing [Internet] 2016.
Collins SA, Vawdrey DK, Kukafka R, Kuperman GJ. Policies for patient access to clinical data via PHRs: current state and recommendations. J Am Med Informatics Assoc [Internet] 2011 Dec 1;18(Supplement 1):i2–7.
Prey JE, Woollen J, Wilcox L, Sackeim AD, Hripcsak G, Bakken S, et al. Patient engagement in the inpatient setting: a systematic review. J Am Med Informatics Assoc [Internet] 2014 Jul 1;21(4):742–50.
Bitton A, Poku M, Bates D. Policy context and considerations for patient engagement with health information technology. In: Grando M, Rozenblum R, Bates D, editors. Information Technology for Patient Empowerment in Healthcare. Berlin: Walter de Gruyter Inc; 2015. pp. 75–90