NR 361 Week 4 Discussion

Student Name

Chamberlain University

NR-361: RN Information Systems in Healthcare

Prof. Name

Date

Case Study: Non-Hodgkin’s Lymphoma and Personal Health Records

A 65-year-old female patient has been diagnosed with Stage 3 non-Hodgkin’s lymphoma. The diagnosis was delivered during a visit to her primary care physician. After returning home, she attempted to review her test and laboratory findings with her family by accessing her personal health record (PHR) online. Unfortunately, she was only able to view a portion of the results. Upon inquiry, the physician’s office clarified that her tests had been performed in different healthcare settings—some in the emergency department, others in a laboratory unaffiliated with her healthcare system, and the rest in her doctor’s office.

This case reflects a common problem in clinical practice, where fragmented healthcare services across multiple facilities prevent patients from retrieving a comprehensive record in one centralized system. Such fragmentation impacts the efficiency of personal health records and challenges patients who rely on PHRs to make informed health decisions.

Pros and Cons of the Situation

Personal health records are intended to provide patients with transparent access to their health data, enabling them to monitor test results, manage treatment plans, and stay informed about their overall care. In this case, the patient gained partial access, but not all her information was available within the PHR due to lack of integration across systems.

Advantages: The system empowers patients by giving them direct insight into their care, promotes active involvement in treatment planning, and supports communication with providers.

Disadvantages: The inability to merge records from different facilities leaves gaps in essential health data, delaying timely decisions. Patients must often contact multiple healthcare entities to obtain missing information, which can be time-consuming and frustrating. Ultimately, this creates barriers to coordinated care and diminishes the potential of PHRs as a comprehensive tool.

Safeguards in Patient Portals and PHRs

Security is a critical concern when handling sensitive health data. Hebda and Czar (2013) describe PHRs as private, secure applications designed to help individuals manage and share health information safely. Access is controlled through authentication methods such as login credentials, and patients may designate proxy users to manage their information when necessary.

Additionally, most PHRs employ encrypted communication channels to ensure the confidentiality of messages exchanged between patients and healthcare providers. Encryption and authentication serve as safeguards to prevent unauthorized access. When PHRs are tethered to electronic health records (EHRs), HIPAA regulations provide further protection by enforcing strict privacy standards. These safeguards not only enhance trust in digital health platforms but also encourage patient engagement in their healthcare journey.

Challenges and Personal Opinions on the Process

Despite the advantages of PHRs, their effectiveness is limited when different healthcare providers do not participate in data-sharing practices. Patients often encounter incomplete records, which complicates their ability to track progress, follow treatment plans, or interpret results. This creates a need for individuals to request physical copies of medical records from various facilities, further fragmenting care.

From a patient-centered perspective, this challenge can also be viewed as an opportunity. Patients may take responsibility by organizing their records at home and ensuring their health history is maintained in a personal system. However, this manual approach is burdensome and highlights the need for broader healthcare system reforms to enhance interoperability among facilities.

Challenges of Limited Access to EHRs

In most cases, PHRs represent only a limited view of the full electronic health record. According to Vydra, Cuaresma, Kretovics, and Bose-Brill (2015), “tethered” PHRs are connected to a provider’s electronic medical record (EMR) and typically provide patients with only subsets of their health data. This restriction hinders the continuity of care, especially after hospital discharges when patients need to review lab results or diagnostic tests.

Furthermore, medical jargon and abbreviations in EHRs may confuse patients, reducing their ability to understand critical information without professional guidance. Incomplete access coupled with complex medical terminology makes it challenging for patients to actively participate in decision-making, which contradicts the primary goal of empowering patients through health information technology.

NR 361 Week 4 Discussion

Table: Key Points from Case Study

References

Hebda, T., & Czar, P. (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.). Pearson.

NR 361 Week 4 Discussion

Vydra, T. P., Cuaresma, E., Kretovics, M., & Bose-Brill, S. (2015). Diffusion and use of tethered personal health records in primary care. Perspectives in Health Information Management, 12(Winter), 1–16.