Patients, Portals, and PHRs

Electronic health records (EHRs) can help physicians communicate better with their colleagues on the health care team - and with their patients, too, to better involve them in their own health care.

"Patient engagement"  improving patients' (and their families') understanding of their health so they are more likely to comply with your recommendations, and are better able to communicate important health information to you  has become a buzz-phrase in the health care industry.

In part, this is because patient engagement is among the goals of meaningful use under the Medicare and Medicaid Electronic Health Record Incentive Programs. Under meaningful use stage 1, five of the 25 criteria are related to engaging patients and families by providing patients an electronic copy of their heath record, a clinical summary, an appropriate reminder, electronic access to their record, and/or patient-specific educational resources.

This is where the EHR comes in. Using a patient portal or the patient's personal health record (PHR), physicians can share relevant information with patients electronically. What are the differences between a portal and a PHR?

  • A patient portal is a secure online website that the medical practice creates and manages. Using a secure username and password, patients (depending on how you set up the portal) can view and print portions of their medical record, including recent doctor visits, discharge summaries, medications, immunizations, allergies, and most lab results. In addition, they might be able to exchange secure e-mail with your health care team, request prescription refills, schedule non-urgent appointments, check benefits and coverage, update contact information, make payments, or download and complete intake forms.
  • Patients create a PHR on their own, and manage their health information privately. They can include information from a variety of sources, including their doctor and other health care professionals or home monitoring systems, as well as diet plans, medication and allergy lists, and the like. PHRs are separate from, and do not replace, the physician's legal medical record for that patient. A PHR can be as simple as a file folder on the patient's computer or flash drive, or it can be a web-based record the patient creates using a free or subscription-based app.

Physicians can send patient information directly to the patient's PHR by using the Direct secure messaging protocol. This standard allows the sending of HIPAA-compliant encrypted emails. Physicians typically can get a Direct email address through their local health information exchange. Patients can get a Direct email address from their PHR company.

PHRs may be better than patient portals for various reasons. Most EHR vendors charge for patient portals. Portals are silos of patient information, and patients may have multiple portals at multiple clinic locations. By securely using the Direct email and communicating via a patient PHR, physicians don't have to pay for or administer the patient portal connected with the EHR.

Want to learn more? Get the on-demand webinar from TMA's Tech Tuesday installment on Hi-Tech Patient Engagement. Learn how to incorporate this new technology for a good patient experience and smooth workflow in your practice. Register now.

 If you have questions about using health information technology in your practice, call the TMA HIT helpline at (800) 880-5720 or email HIT@texmed.org. Learn more about the incentive programs at www.texmed.org/EHRIncentive.

Published Oct. 10, 2013


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