![]() ![]() The current principal driver of patient portal development is the meaningful use (MU) criteria of the CMS EHR incentive program. These initiatives also coincided with the broad social movement towards adoption and daily use of powerful information and communication sharing tools such as smartphones and social media, illustrating the readiness of the general population to embrace technology in a new socially interactive way. However, patient portals did not gain widespread use until 2006 when several initiatives coincided, including the launch of ePHRs by Microsoft and Google, the awarding of Centers for Medicare and Medicaid Services (CMS) contracts to private firms to conduct feasibility studies of ePHRs using existing claims data from Medicare programs, and Blue Cross and Blue Shield Association and America’s Health Insurance Plans’ announcement to develop data-sharing programs that would ultimately support ePHR development. Patient portals were introduced and adopted by a few large health care organizations in the late 1990s (eg, M圜hart at the Palo Alto Medical Foundation and Indivo at Boston Children’s Hospital). Because there is little that health care organizations can do to initiate patient engagement using an untethered ePHR, this literature review is focused exclusively on the patient portal, directly linked to an EHR. ![]() Thus, the value of an untethered ePHR is determined by a person’s willingness to manage and maintain their ePHR information. This means an individual manually enters all information or grants permission for the information to be transferred to the ePHR, from a specific source like a laboratory or pharmacy, and determines who will have access. In contrast, an untethered ePHR is under the control of the patient. In some instances, patients may enter data to populate the EHR. ![]() In general, patient information from the EHR such as the problem list, allergies, and lab test results populate the patient portal. While an electronic personal health record (ePHR) tethered to an electronic health record (EHR), also known as a patient portal, is currently recognized as a promising mechanism to support greater patient engagement, questions remain about how health care leaders, policy makers, and designers can encourage adoption by both providers and patients and what factors might contribute to sustained utilization.ĭefinition and Background of Patient PortalsĪn ePHR that directly links, or is “tethered”, to an EHR is most commonly referred to as a patient portal. Ĭurrently, there is an increasing awareness of health care system’s responsibility to provide easily accessible ways for patients to be engaged in their own care by creating effective partnerships that lead to the patient’s ability to make competent and well-informed decisions. AHRQ also defines patient engagement from a systems perspective as “a set of behaviors by patients, family members, and health professionals and a set of organizational policies and procedures that foster both the inclusion of patients and family members as active members of the health care team and collaborative partnerships with providers and provider organizations”. ![]() The patient-centric definition of patient engagement by the Agency for Healthcare Research and Quality (AHRQ) is “the involvement in their own care by individuals (and others they designate to engage on their behalf), with the goal that they make competent, well-informed decisions about their health and health care and take action to support those decisions”. Patient engagement has been identified as an essential dimension of the multifaceted solution to the cost/quality crisis in US health care. ![]()
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