Healthcare Informatics response

Discussion 3

Laura

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The article, “The Impact of Health Literacy on a Patient's Decision to Adopt a Personal Health Record,’ gave many different interesting insights in the positive outcomes of using electronic medical records and also the hindrances associated with implementing them.  As stated in the article, “One advantage of the PHR is its ability to provide improved communication between the patient and physician and allow the patient to become more engaged in the healthcare process.  Better physician-patient communication and increased patient involvement in decision making are vital components of a successful self-management program with improved patient outcomes and overall satisfaction with care. Engaged patients want to understand the content of the PHR, including diseases and medications. This understanding is important in that it allows patients to recognize the benefits of access to their health information.” (Noblin, Wan, & Fottler , 2012)  Engaging patients in their own healthcare needs and routines is ideal for increased positive healthcare.  As a nurse I have seen many patients not understand what medications they are on or why they are taking them or even how to properly take them.  Offering information that is easily accessed and having the ability to ask questions regarding their health in between visits can increase not only how people take care of themselves but how they can increase what they are doing for themselves at home.

One of the main problems with electronic health records is whether or not they are feasible for all of patients.  Many factors need to be included in the process of utilizing electronic records from home, such as internet access and understanding of the system, and understanding what the information is saying.  In the article, “The health literacy demands of electronic personal health records (e-PHRs): An integrative review to inform future inclusive research,” located in the journal “National Library of Medicine,” research was completed that shows, “The health literacy demands of e-PHRs are high and could potentially exclude many patients unless strategies are adopted to support their use of these systems. Developing strategies for all patients to meet or reduce the high health literacy demands of e-PHRs will be important in population-wide implementation.” (Hemsley, Rollo, Georgiou, Blanandin, & Hill, 2017)  Providing education on the systems being used, how to access them and how to navigate them is key in getting patients to not only utilize them but to value them.  It seems that the most beneficial way to use electronic health records is to make sure everyone has access to them in the first place and then to make sure that education is provided on how to use them.  This is something that does not happen overnight, it could take decades to get the majority of patients using electronic records. 

 

Biblical Integration

“Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us, fixing our eyes on Jesus, the pioneer and perfecter of faith. For the joy set before him he endured the cross, scorning its shame, and sat down at the right hand of the throne of God. Consider him who endured such opposition from sinners, so that you will not grow weary and lose heart.”  Hebrews 12:1-3  I interpret this passage to mean that through God we can accomplish anything, even what we may have never thought possible. 

Hemsley, B., Rollo, M., Georgiou, A., Blanandin, S., & Hill, S. (2017). The health literacy demands of electronic personal health records (e-PHRs): An integrative review to inform future inclusive research. National Library of Medicine.

Noblin, A., Wan, T., & Fottler , M. (2012). The Impact of Health Literacy on a Patient's Decision to Adopt a Personal Health Record. Perspectives in Health Information Management.

 

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Emily Mosley 

Discussion #3

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As a nurse, I have always wondered why we ask patients what their highest level of education is and how they learn best. Sometimes the patients would just laugh and answer the question or sometimes they would become offended that we even want to know because they are embarrassed that they may only have a few classes of high school and are disappointed with themselves. However, once I or another nurse would explain that it would be so we could properly teach them their discharge instructions or better help them understand any procedure during their hospitalization, they would change their mind and understand.

According to “The Impact of Health Literacy on a Patient’s Decision to Adopt a Personal Health Record” article, “Health literacy is defined as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” (Noblin, Wan, & Fottler, 2012). Low health literacy can lead to poor outcomes, increased usage of emergency rooms, more frequent hospitalizations, and inability to manage chronic diseases. Low literacy indicators are having less than a high school education, speaking English as a second language, and advanced age with decline mental capacity, visual acuity, and/or auditory acuity. The important thing to note about low literacy patients is that they will need tools to aid them in interpreting and understanding the contents of personal health records to improve understanding the diseases, medications, and terminology. We should not forget, though, that high literacy patients may need those same aids.

Ajzen and Fishbein did study to see if the theory of reasoned action is based on behavioral intention as the main predictor of actual behavior. They say that people will respond to social pressures which are called “subjective norms”. Subjective norms refers to the beliefs that significant others view the behavior as favorable and pressures are taken together within an individual’s attitude to determine intention and ultimately change behavior. “Subjective norms also affect the likelihood of a behavior. According to Ajzen and Fishbein, “the more a person perceives that others who are important to him think he should perform a behavior, the more he will intend to do so.”” (Noblin, Wan, & Fottler, 2012). In other words, if physicians were to encourage their patients to have a PHR and use the PHR, the more likely they will and the change in behavior will be positively affected.

In a cross-sectional study, an  eHEALS instrument was used which measures a person’s knowledge, comfort, and perceived skill level to find, apply, and evaluate electronic health information to health problems. This research was performed to study patient’s intentions of using a PHR and its association with health literacy, income, age, and education. 74 percent of the participants said that they would use a PHR, if provided, and 65 percent of those patients were perceived to have a high literacy level. Interestingly, 52% of the patients at risk for low health literacy had a high school level education or less, seven percent were 71 years or older, and 59% made $20,000 a year or less, however, most were willing to adopt the PHR. Physicians have to be willing to teach their patients how to use the PHR and have patience with them. This study did state that providing patients with education and PHRs, there is potential to decrease healthcare encounters and costs for care.

In Luke 6:40, the bible says, ““The student is not above the teacher, but everyone who is fully trained will be like their teacher.” (Bible Gateway, 2016). This can relate to the journal article and health care because we can be considered teachers at times. We have to remember that we are never above our patients and that we must help them learn so they can better themselves and learn what we are teaching them.

References

Bible Gateway. (2016). Retrieved from The Holy Bible, English Standard Version: https://www.biblegateway.com/passage/?search=Luke+6%3A40&version=ESV

Noblin, A. M., Wan, T. T., & Fottler, M. (2012). The Impact of Health Literacy on a Patient's Decision to Adopt a Personal Health Record. Perspectives in Health Information Management.

 

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