Discussion: Week 4 Personal Health Records/NR 361

Your patient has a Personal Health Record…Now what?

Discussion

Purpose

This week’s graded discussion topic relates to the following Course Outcomes (COs).

Course Outcomes

This assignment enables the student to meet the following course outcomes:

CO 4: Investigate safeguards and decision-making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers. (PO 4)

CO 5: Identify patient care technologies, information systems, and communication devices that support safe nursing practice. (PO 5)

Due Date

During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week):

Posts in the discussion at least two times, and

Posts in the discussion on two different days

Total Points Possible: 50 points

Preparing the Discussion

Discussions are designed to promote dialogue between faculty and students, and students and their peers. In discussions students:

Demonstrate understanding of concepts for the week

Integrate outside scholarly sources when required

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Engage in meaningful dialogue with classmates and/or instructor

Express opinions clearly and logically, in a professional manner

Use the rubric on this page as you compose your answers.

Best Practices include:

Participation early in the week is encouraged to stimulate meaningful discussion among classmates and instructor.

Enter the discussion often during the week to read and learn from posts.

Select different classmates for your reply each week

Discussion Question

Case Study: A 65-year-old woman was just been diagnosed with Stage 3 non-Hodgkin’s lymphoma. She was informed of this diagnosis in her primary care physician’s office. She leaves her physician’s office and goes home to review all of her tests and lab results with her family. She goes home and logs into her PHR. She is only able to pull up a portion of her test results. She calls her physician’s office with this concern. The office staff discussed that she had part of her lab work completed at a lab not connected to the organization, part was completed at the emergency room, and part was completed in the lab that is part of the doctor’s office organization.

The above scenario might be a scenario that you have commonly worked with in clinical practice. For many reasons, patients often receive healthcare from multiple organizations that might have different systems.

As you review this scenario, reflect and answer these questions for this discussion.

What are the pros and cons of the situation in the case study?

What safeguards are included in patient portals and PHRs to help patients and healthcare professionals ensure safety?

Do you agree or disagree with the way that a patient obtains Personal Health Records (PHRs)?

What are challenges for patients that do not have access to all of the PHRs? Remember, only portions of the EHRs are typically included in the PHRs.

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Grading

To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric. See Syllabus for Grading Rubric Definitions.

RNBSN_50_Point_Discussion_Rubric_1_21

RNBSN_50_Point_Discussion_Rubric_1_21
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Answer Post

•Answers the discussion question(s) in a detailed manner, and

•Demonstrates excellent knowledge and understanding of course concepts
16 pts

100% Excellent

Answers the discussion question(s) in a detailed manner and demonstrates excellent knowledge and understanding of course concepts.

14 pts

88% Good

Answers the discussion question(s) but detail is lacking, and demonstrates good knowledge and understanding of course concepts.

13 pts

80% Fair

Partially answers the discussion question(s) and partially demonstrates knowledge and understanding of course concepts.

6 pts

38% Poor

Minimally answers the discussion question(s) and minimally demonstrates knowledge and understanding of course concepts.

0 pts

0% Missing

Does not answer the discussion question(s).

16 pts
This criterion is linked to a Learning Outcome Scholarly Sources

•Integrates evidence from assigned reading OR lesson,

•Integrates evidence from at least one outside scholarly source,

•All sources are credited within the body of the post,

•Evidence supports the discussion, and

•APA format is not required but is encouraged.
12 pts

100% Excellent

Integrates evidence from assigned reading OR lesson AND from at least one outside scholarly source. All sources are credited within the body of the post. Evidence supports the discussion.

11 pts

88% Good

Integrates evidence from assigned reading OR lesson only. All sources are credited within the body of the post. Evidence supports the discussion.

10 pts

80% Fair

Integrates evidence from outside scholarly source only. All sources are credited within the body of the post. Evidence supports the discussion.

5 pts

38% Poor

Lists sources at conclusion of post but does not integrate/credit evidence into body of post OR integrates evidence but evidence does not support the discussion.

0 pts

0% Missing

Does not integrate any evidence.
12 pts

This criterion is linked to a Learning Outcome Reply Post

•Replies to a classmate’s and/or instructor’s post,

•Reply post provides additional information or clarification, and

•Reply post adds excellent depth to the discussion.

14 pts

100% Excellent

Replies to a classmate’s and/or instructor’s post by providing additional information or clarification. Reply post adds excellent depth to the discussion.

12 pts

88% Good

Replies to a classmate’s and/or instructor’s post by providing additional information or clarification. Reply post adds good depth to the discussion.

11 pts

80% Fair

Replies to a classmate’s and/or instructor’s post. Limited information or clarification provided. Brief reply post adds fair depth to the discussion.

5 pts

38% Poor

Replies to a classmate’s and/or instructor’s post. Reply does not provide additional information or clarification. Brief reply post does not add depth to the discussion.

0 pts

0% Missing

No reply post to classmates or instructor.

14 pts
This criterion is linked to a Learning Outcome Communicates Professionally

All posts:

•are clear and concise,

•are respectful, civil, and caring, and

•contain excellent English grammar, spelling, and punctuation.

8 pts

100% Excellent

All posts are clear, concise, respectful, civil, and caring. Posts contain excellent English grammar, spelling, and/or punctuation.

7 pts

88% Good

All posts are clear, concise, respectful, civil, and caring. Posts contain good English grammar, spelling, and/or punctuation.

6 pts

80% Fair

All posts are respectful, civil, and caring but are not clear or concise. Posts contain fair English grammar, spelling, and/or punctuation.

3 pts

38% Poor

All posts are not clear and concise, AND contain poor English grammar, spelling, and/or punctuation.

0 pts

0% Missing

All posts are not respectful, civil, and caring.
8 pts
This criterion is linked to a Learning Outcome Participation

During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week):

•Posts in the discussion at least two times, and

•Posts in the discussion on two different days
0 pts

No Points Deducted

During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week): •Posts in the discussion at least two times, and •Posts in the discussion on two different days

0 pts

Points Deducted (-5 Points)

During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week): •Does NOT post in the discussion at least two times AND/OR •Does NOT post in the discussion on two different days
0 pts

Total Points: 50

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NR 361 Week 4: Discussion: Personal Health Records

What are the pros and cons of the situation in the case study?

By improving patient health information’s accuracy and completeness, accelerating the delivery of care, improving care coordination, and boosting patient and family transparency, the primary objective of implementing technologies like electronic health records (EHRSs) is to improve patient safety and quality of care (Gandrup et al., 2020). One significant advantage of electronic health information is its potential to involve patients in their care and offer virtual access to carers through email and web platforms, thereby enhancing convenience and accessibility for patients. In this case study, the client had the opportunity to discuss the information provided by her healthcare provider with her family, enabling her to make an informed decision about her care. This enables her to reduce her treatment waiting time, access and manage her health information, ask well-informed questions based on her records, and enhance medication safety during treatment.

However, there are challenges associated with electronic medical records. The patient’s records with this provider contained incomplete information in the case study. This is a recurring observation I have made while working directly with clients and their access to electronic medical records. Patients face challenges accessing their health data due to underutilized patient portals, unclear security protocols, and inadequate health IT interoperability. Some of the enduring challenges clients and the healthcare industry face include facilitating communication and coordination of care within integrated teams by utilizing tablet devices and other EHRs. Clinical documentation is frequently fragmented, hindering the ability to obtain a comprehensive understanding of a patient’s story (Abd-alrazaq et al., 2019). Furthermore, the integration between systems lacks communication.

What safeguards are included in patient portals and PHRs to help patients and healthcare professionals ensure safety?

Given the abundance of data circulating globally, it is imperative to establish protective measures for safeguarding Personal Health Records (PHRs). To ensure the security of health information, EHR patient portals must be hosted on a safe connection and accessed through an encrypted login protected by a password. HIPAA identifies three critical pillars for safeguarding protected health information: administrative security measures, physical security measures, and technical measures (Kim et al., 2019). The safeguards include transmission security, authentication, access control based on organizational roles, audit controls, and data integrity.

Do you agree or disagree with how a patient obtains Personal Health Records (PHRs)?

I concur with the notion that they should be granted access. Patient access to health data is crucial for empowering patients with information regarding their medical conditions. It also involves the patient as a collaborator in the provision of healthcare. Granting patients access to their health records enables them to acquire knowledge about their health, actively participate in their healthcare, make informed decisions, enhance the quality of their care, increase engagement, foster a sense of empowerment in managing their health, monitor chronic illnesses, adhere to treatment plans, and identify and rectify any errors (Dubovitskaya et al., 2019). However, there are disadvantages associated with having unrestricted access to all records. Patients face challenges accessing their health data due to underutilized patient portals, unclear security protocols, and insufficient health IT interoperability. The case study focused on achieving IT interoperability to facilitate the sharing data visualizations on a single platform for clients.

What are the challenges for patients who do not have access to all of the PHRs? Remember, only portions of the EHRs are typically included in the PHRs.

According to Dubovitskaya et al. (2019), the national aim of reducing health inequalities cannot be achieved unless the rules for collecting healthcare demographic data are aligned with public health requirements. This phenomenon pertains to the factors influencing the visibility of certain records over others in the overall context. Scanned items within an EMR are not visible to clients. This document can serve as a consultation report regarding patient care, although it is transmitted using an outdated fax method. There are no options for data dumping information in the EMR system except storing it in a file folder. This can lead to treatment delays when seeking consultation from a specialist or obtaining a comprehensive diagnosis due to missing information.

References

Abd-alrazaq, A. A., Bewick, B. M., Farragher, T., & Gardner, P. (2019). Factors that affect the use of electronic personal health records among patients: A systematic review. International Journal of Medical Informatics, pp. 126, 164–175. https://doi.org/10.1016/j.ijmedinf.2019.03.014

Dubovitskaya, A., Shukla, R., Zambani, P. S., Schumacher, M., Aberer, K., Xu, Z., Idnani, N., Lachhani, R., Wang, F., Swaminathan, A., Jahangir, M., Baig, F., Chowdhry, K., Ryu, S., & Stoller, S. (2019). ACTION-EHR: Patient-Centric Blockchain-Based EHR Data Management for Cancer Care (Preprint). Journal of Medical Internet Research, 22(8). https://doi.org/10.2196/13598

Gandrup, J., Ali, S. M., McBeth, J., van der Veer, S. N., & Dixon, W. G. (2020). Remote symptom monitoring integrated into electronic health records: A systematic review. Journal of the American Medical Informatics Association, 27(11). https://doi.org/10.1093/jamia/ocaa177

Kim, E., Rubinstein, S. M., Nead, K. T., Wojcieszynski, A. P., Gabriel, P. E., & Warner, J. L. (2019). The Evolving Use of Electronic Health Records (EHR) for Research. Seminars in Radiation Oncology, 29(4), 354–361. https://doi.org/10.1016/j.semradonc.2019.05.010