PHRs also make the patient encounter more efficient. “With a PHR, we can have a productive visit, and everyone walks out of the room smiling. They got what they needed, and patients have great communication with their doctors,” Wolter says.
If a patient travels frequently or lives part of the year in a different location—say, a New Yorker who goes to Florida in the winter—then PHRs help that patient easily share health information with physicians in other locations, Dr. Bielory says. PHRs also allow relatives involved in a family member’s care to easily review relevant clinical information, says health literacy educator Jann Keenan, EdS, president, The Keenan Group Inc., Ellicott City, Md.
With all of its advantages, you’d think rheumatology patients would almost always arrive at your office with PHRs in hand. However, “it’s extremely infrequent that patients are using PHRs,” Dr. Oberstein says. Even getting patients to bring reports or documents prepared by referring doctors can be tricky, she adds.
Dr. Oberstein has seen younger patients share health information with providers via their smartphones or tablets, but tech know-how isn’t always a skill honed by rheumatology patients, who may be older or have difficulty using certain devices because of their joint problems.
A study of the growth of PHRs in New York (not specific to rheumatology) found that reported PHR use increased from 11% in 2012 to 17% in 2013.1 Researchers found that those who were married, used prescription medication, had more education and used the Internet or e-mail daily were more likely to have PHRs. Many more patients are open to the idea of PHRs for themselves, their family members and even their pets, although they may not yet formally keep PHRs.
Limitations
PHRs have many advantages, but they also come with baggage, Wolter says. Patients may not always know what information they need to include in a PHR (see sidebar, right, for links that guide patients in how to create a PHR). Plus, they may not know they can ask for history and physical reports or lab data, Wolter adds.
Then there’s the health literacy challenge. The numeracy and literacy skills required to understand one’s own health information are demanding, says Keenan. Patients with low health literacy are usually less likely to view lab results, communicate with providers, request medication refills and make medication appointments with patient portals connected to EHRs, according to a 2013 report in the journal Psychology and Aging.2