Patient Portals Essay Main Post
Within the healthcare world, there are many different problems and stressors facing the healthcare community at any given time. One issue that I feel has recently affected my practice is the creation of patient portals in response to a new national requirement dictating that patients have live access to their charts. The purpose of this Patient Portals Essay discussion post is to further describe this healthcare issue and how it has impacted my work setting as well as detail what changes have been implemented at my setting in response to this issue.
In skilled nursing facilities or long-term care, patients have always had eventual access to their charts, but not immediate, live access. Historically, they have had to submit an official request for documents and wait a period of time before receiving paper copies. However, as healthcare technology has advanced further and further, patient charts have become almost completely electronic. It was inevitable, then, that the way patients interacted with their health records also change. Then, in 2016, a new regulation was passed called the 21st Century Cures Act (Arvisais-Anhalt et al., 2022). This regulation, in part, contained a requirement that by October 6, 2022, healthcare organizations give all patients live access to their electronic medical records (Durieux et al., 2022). As all healthcare organizations work towards the all-important Quadruple Aim, including the aim of improving patient experiences and outcomes, the hope is that patient portals can assist in this by encouraging patient involvement in their own care (Park et al., 2018).
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This new issue of patients having live access to their charts can impact long-term care facilities in a few different ways. First, it will be important for nurses and physicians to understand that patients are now going to be able to read their notes immediately after they are entered. This can potentially have an impact on the provider/patient relationship if a patient reads something in their chart that they disagree with or read a hard truth they are not ready to hear. For example, a provider charts on a diabetic patient who has the potential to lose their foot because they are failing to follow their diet or because they continue to smoke. Even though this documentation is true, if the patient reading it is not ready to hear this, they can respond negatively. Patient portals can also can affect facilities in a financial way. The development of patient portals and the software and manpower required to create and maintain them costs a significant amount of money. Organizations will have to factor this in as a new cost of doing business in healthcare that was not present before Patient Portals Essay. Smaller organizations may struggle to find the funds to comply.
In response to this new regulation my organization has made numerous changes. First, they have had to work with a company to create patient portals for the facility, including the ability to create patient logins and passwords for access to their charts. Second, we have had to create new policies to encompass the use of these patient portals, and how to ensure that patient information is protected and HIPPA is followed. We have also had to add new documents to the patient admission packets that include information on patient portals and gives patients the option to participate or opt out. We have found that many older patients do not wish to have access to the portals while younger patients who are more used to this sort of technology are much more likely to participate Patient Portals Essay.
Overall, even with all the struggles that have accompanied this new regulation, I feel that patients having live access to their charts is a positive change. One of our most significant roles as nurses is that of patient advocate and with the development of patient portals we must advocate for patients by encouraging them to participate in their own care and therefore advocate for themselves. The more a patient is able to understand and learn about their own disease process and plan of care, the more they are able to make informed decisions about it and anything that encourages this is certainly a worthy endeavor.
References
Arvisais-Anhalt, S., Lau, M., Lehmann, C. U., Holmgren, A. J., Medford, R. J., Ramirez, C. M.,
& Chen, C. N. (2022). The 21st Century Cures Act and Multiuser Electronic Health
Record Access: Potential Pitfalls of Information Release. Journal of Medical Internet
Research, 24(2), e34085. https://doi.org/10.2196/34085Links to an external site.
Durieux, B. N., DeCamp, M., & Lindvall, C. (2022). 21st Century Cures Act: ethical
recommendations for new patient-facing products. Journal of the American Medical
Informatics Association, 29(10), 1818–1822. https://doi.org/10.1093/jamia/ocac112Links to an external site.
Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment
models influence primary care and its impact on the Quadruple Aim. Journal of the
American Board of Family Medicine, 31(4), 588–604.
https://doi.org/10.3122/jabfm.2018.04.170388 Links to an external site.
Patient Portals Essay response
Good post!
I have mixed feelings about patient portals. They became increasingly popular during the Covid-19 pandemic and allowed us to better serve our patients in unprecedented times. I know that they promote patient-centered care and allow our patients to be more actively involved in their plan of care, but I also believe they can cause a negative patient-provider relationship. I work in the mental health field, so I have also thought many times about patients seeing what I chart about them. There are times that I mention my patients being psychotic, delusional, or paranoid. If my patients were to read this as I am actively working with them, they may feel that they cannot trust me. So while these portals are meant to improve patient satisfaction, they may also jeopardize it. We must also consider health literacy when discussing the pros and cons of patient portal access. Health literacy describes how easily a patient can obtain, process, and understand basic health information (Yulong et al., 2015). If they read the information we chart, but do not understand it or know how to interpret the results, patients may make poor health-related decisions Patient Portals Essay. To tag along with your example, if their chart states that their A1c is 7.2mg/dL and they believe this to be within range, they may not change their dietary or exercise habits. As providers, it is important we remain diligent about educating our patients and do not rely on technology to explain everything.
What I enjoy about the patient portals is the easy access to appointment reminders and medication information. In my experience, psychiatric patients struggle with compliance. Many of them forget about their appointments or do not have a way to organize their schedules/calendars. With the patient portal, patients are able to see when their next appointment is (Leung et al., 2019). Some portal systems even send notification reminders to the patients. Patient portals also allow our patients to review their medications to see what they are taking, what dosage is prescribed, how often they should be taking it, and when they are due for a refill. However, many patients stated they would not request a refill via their portal, and are more likely to call their pharmacy or physician’s office (Leung et al., 2019). With easy access to this information, patients are more likely to remain compliant with their medications. This will improve patient outcomes significantly.
References:
Leung, K., Clark, C., Sakal, M., Friesen, M., & Strudwick, G. (2019). Patient and Family Member Readiness, Needs, and Perceptions of a Mental Health Patient Portal: A Mixed Methods Study. Studies in Health Technology and Informatics, 257, 266–270.
Yulong, G., Orr, M., & Warren, J. (2015). Health literacy and patient portals. Journal of Primary Health Care, 7(2), 172–175. https://doi.org/10.1071/hc15172 Patient Portals Essay