Case Study - Participatory Healthcare Informatics
Article Summary
The Impact of Health Literacy on a Patient’s Decision to Adopt a Personal Health Record
The advancement in health technology has made it easier for patients to get involved in
their healthcare mostly through Personal Health Records (PHR) and Patient Portals. For these to
achieve their intended purposes, the patient must have knowledge of these technologies and
know how to utilize it. This article was research that sort to find out the willingness of patients to
adopt a Personal Health Record (PHR) depending on their health literacy. Factors such as
education, age, living with disability, and the economic status of an individual contribute to
health literacy. Without health literacy, patients would not see the importance of PHR (Noblin et
al2012). Illiteracy has become an increasingly important problem, especially as it relates to
health care. A national survey found that almost half of the adult population has deficiencies in
reading or computation skills. Literacy is defined as the basic ability to read and speak English,
whereas functional health literacy is the ability to read, understand, and act on health
information. (Andrus & Roth 2012)
The authors (Noblin et al 2012) defined Health literacy 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 a concept that describes a patient's ability
to understand materials provided by physicians or other providers. Several factors, including
education level, income, and age, can influence health literacy. Literacy in health is essential as it
opens the patients to information that will them take the needed action for their well-being.
Personal Health Records is an integral part of patients tracking their health and as stated in the
article a PHR is defined as “an electronic, lifelong resource of health information needed by
individuals to make health decisions.” As implied by its name, the PHR is maintained by the
patient and is not considered to be a part of the legal medical record. This transitions healthcare
focus from the doctor’s office to the patient’s daily routine The PHR can provide direct and
timely communication with the physician and empower the patient to be involved and participate
in the decision-making process about his or her health. The hypothesis for research were the
demographic characteristics of a population and health literary. It was conducted in Florida in
November and December 2009 with patients of a physician practice. A pilot study was first done,
and it showed high reliability and other statistical measures were reasonable too.
The instrument that was used to measure a patient’s knowledge, comfort, and perceived
skill to find evaluate and apply electronic health information to health problems was the eHealth
Literacy Scale (eHEALS). Out of the 562 patients for the research, 74% indicated that they will
adopt a PHR. In all, when patients are provided with education and other tools like access to
their medical records, it is likely to minimize healthcare encounters and costs (Noblin et al
2012). This is patient engagement in their own health care which is a great tool in ensuring a
healthier patient. As defined by the National Institutes of Health, patient engagement is patient
care that establishes a partnership among practitioners, patients, and their families (when
appropriate) to ensure that decisions respect patients’ wants, needs, and preferences and solicit
patients’ input on the education and support they need to make decisions and participate in their
own care (Shanholzter &Ensign 2021).
The researchers found possible limitations which included the office staff consistently
explaining the purpose and importance of adopting the PHR to the patient coupled with the great
care some receive, wanted to please the physician, and so gave good rather than actual answers.
Not all the data was used in the manner of their original formulation of the eHEALS
questionnaire. Again, the questionnaire was only available in English so it did not include
participants who could not read English. The results indicated that 74% of the practice's patients
do intend to adopt a PHR if it is made available to them. These findings are encouraging in this
population of candidates who are socioeconomically unlikely to adopt a PHR (low income, high
school education).
An insight I gained from this article is that an individual will develop a positive or
negative attitude toward a behavior and will also respond to social pressures about the behavior
was interesting. This is the theory of reasoned action based on behavioral intention as the main
predictor of actual behavior. The more a person perceives those others who are important to him
think he should perform a behavior, the more he will intend to do so (Ajzen &Fishbein).
Therefore, if a physician is a strong advocate for the PHR and the patient also sees the value and
importance of the PHR, the intention to change behavior will be positively affected. The
physicians of the practice studied in the present research were supportive of the use of the PHR
by all patients (Noblin et al 2021). Also, intriguing is the follow-up research that will be done to
determine if patients and providers indeed access the data and use it to improve health status and
outcomes.
“Do you not know that your bodies are temples of the Holy Spirit, who is in you, whom
you have received from God? You are not your own; you were bought at a price. Therefore,
honor God with your bodies” (New International Version, 1 Corinthians 6:19-20). As patients
actively engage in their own healthcare through the adoption and use of a PHR and patient
portals, patients in a way honor God with their bodies by keeping it in a state of health with the
help of physician/providers.
References
Andrus. R. M & Roth., M. (2012). Pharmacotherapy: The Journal of Human Pharmacology and
Drug Therapy, 22(3): 282-302. https://doi.org/10.1592/phco.22.5.282.33191
Ajzen I. & Fishbein M. Understanding Attitudes and Predicting Social Behavior. Englewood
Cliffs, NJ: Prentice-Hall; 2005. ISBN: 0139364358
New International Version. Bible Gateway. https://www.biblegateway.com/passage/?
search=1%20Corinthians%206%3A19-20&version=NIV
Noblin. A. M., Wan T.H.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 (Fall 2012): 1–13.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510648/#B24
Shanholtzer, B., & Ensign, A, (2021). Healthcare informatics. McGraw-Hill Education.
https://learning.mheducation.com/static/awd/index.html?_t=1657039371090#/
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