What is the difference between Patient Portals and Personal Health Records (PHRs)? Traditionally, a Patient Portal is an extension of an EHR, EMR, or Hospital system. Data from one of these systems is published to the portal. The patient is provided with a secure login and can view results or clinical information and interact with healthcare providers by submitting messages, booking appointments, or requesting medication renewals. The Portal is controlled by the source system (EMR/EHR/Hospital). On the other hand, the Personal Health Record (PHR) is more patient centric, is controlled by a patient or family member, and may or may not be connected to a doctor or hospital (i.e. it may be tethered or untethered). Information in the PHR is shared at the discretion of the patient.
The above description is quite simplistic and based upon the manner in which these tools have generally been developed; however, PHRs and Patient Portals are now beginning to merge both capabilities into a single product. For example, an EHR vendor or hospital system may offer a patient portal that is accessed through a browser as well as a PHR that is under the control of the patient. The key differentiation is control. In the PHR, a patient controls who has access to their data vs. the EMR and EHR, in which the provider or health organization controls the information.
A study designed to examine patient loyalty as measured by retention in a health plan was conducted between 2005 and 2008 with 394,000 Kaiser Permanente Northwest members. Study authors estimated retention rates between My Health Manager users (the Kaiser Permanente PHR) and non-users. In this study, the use of a Personal Health Record linked to the Kaiser Permanente Electronic Health Record, was a significant predictor of patient loyalty. Users of the PHR were 2.578 times more likely to choose to remain members than were non-users. (Am J Manag Care. 2012;18(7):e248-e253)
In a time-pressured healthcare system, are there better mechanisms to share this information? Phone calls, although personal, have logistical challenges due to the availability of either the physician or office staff to provide the services, as well as the need to leave voice messages when patients are not available to take a call.
Benefits of Personal Health Records include:
- Continuity of records — people move, change jobs, and change doctors.
- Patients becoming more engaged in managing their own healthcare is associated with better outcomes.
- Passing control for certain tasks over to patients can reduce telephone calls and other administrative workloads in practices, e.g. view own lab results and reports.
- One caution: information in a PHR can be more accurate, reliable, and up to date; however, it requires effort from patients and their care providers.
Benefits of Patient Portals include:
- Ability to view lab and diagnostic imaging results through secure login.
- Appointment scheduling and prescription renewal requests.
- Ability to communicate with healthcare providers.
- Reminders and notifications for appointments, results, and upcoming diagnostic investigations.
- Downloadable registration forms or pre-clinic assessment forms.
- Consumer health information on relevant diseases or clinical conditions.
Under the Stage 2 Meaningful Use requirements (which will begin as early as 2014), >5% of patients must send secure messages to their physician and >5% of patients must access their health inforomation online. Offering a patient portal will allow practices to meet these requirements.
Have you had experience with PHRs or Patient Portals? What are the benefits and challenges? Share your thoughts or comments.