NR 361 Week 4 Discussion
Student Name
Chamberlain University
NR-361: RN Information Systems in Healthcare
Prof. Name
Date
Week 4 Discussion Topic
NR 361 Case Study: Stage 3 Non-Hodgkin’s Lymphoma Diagnosis and PHR Access
A 65-year-old woman has recently been diagnosed with Stage 3 non-Hodgkin’s lymphoma. She was informed of this diagnosis in her primary care physician’s office. After leaving the appointment, she went home to review her laboratory and test results with her family using her Personal Health Record (PHR).
However, she discovered that she could only access part of her test results. This was due to the fact that her laboratory work was conducted at multiple facilities: some tests were performed at a lab unaffiliated with her physician’s organization, some in the emergency department, and others within the clinic’s own laboratory. Because each facility utilized different systems, her PHR did not display all the data in one place.
This case reflects a common challenge in healthcare, where patients receive care from multiple providers and institutions that use non-integrated health information systems. This raises important considerations about the benefits, limitations, safeguards, and patient challenges associated with PHRs.
Pros and Cons of the Situation
Advantages of PHR Access
Having access to a PHR empowers patients by allowing them to view their medical data, including test results, diagnoses, and clinical notes. This transparency promotes active patient engagement, encourages informed decision-making, and supports shared communication between the patient and healthcare team. Moreover, PHRs can enhance continuity of care by providing a consolidated history of treatments and health events, potentially leading to improved outcomes.
Disadvantages in This Case
In the presented case, the main disadvantage was the incomplete synchronization of medical data from different facilities into one unified PHR. Since test results from external labs or unrelated healthcare systems were not integrated, the patient experienced gaps in her medical record. This incomplete data can create confusion, delay decision-making, and require the patient to manually obtain records from other institutions.
NR 361 Week 4 Discussion
| Pros | Cons |
|---|---|
| Patients can review test results, diagnoses, and care plans. | Incomplete synchronization between multiple systems. |
| Encourages patient engagement and informed decision-making. | Requires manual record retrieval from other facilities. |
| Improves care coordination when fully integrated. | Potential delays in diagnosis and treatment planning due to missing data. |
Safeguards in Patient Portals and PHRs
PHRs and patient portals have multiple layers of security designed to protect sensitive health information. According to Hebda and Czar (2013), a PHR is “a private, secure application through which an individual may access, manage, and share health information” (p. 325). Access is typically restricted to the patient and any authorized proxy users.
A key safeguard is secure messaging, which uses encryption and user authentication to prevent unauthorized interception. Unlike standard email, secure messaging ensures that communication between patients and healthcare providers is protected. Additionally, when PHRs are integrated with Electronic Health Records (EHRs) during hospital stays, they are subject to HIPAA regulations, which mandate strict privacy and security protocols.
These safeguards not only maintain confidentiality but also strengthen trust between patients and providers, encouraging patients to actively use digital tools for their healthcare management.
Agreement or Disagreement with the Process
The concept of PHRs is generally beneficial, as it centralizes health information, facilitates ongoing health monitoring, and enables direct communication with healthcare providers. Patients can review test results, manage medication lists, schedule follow-up appointments, and track progress over time.
However, the major drawback is the lack of universal interoperability. If healthcare systems and laboratories do not share standardized integration protocols, the PHR may contain only partial information. In these cases, patients may need to request printed records to ensure they maintain a complete health file at home.
Despite this limitation, the process is still valuable when combined with patient education on how to obtain and store complete medical information.
Challenges When Patients Lack Full EHR Access
Patients who can only view a portion of their EHR through a tethered PHR face several obstacles. As Vydra et al. (2015) explain, tethered PHRs provide a subset of EMR data, allowing patients to access parts of their record but not the entirety. This limitation can impair care coordination and hinder the patient’s ability to understand the full scope of their diagnosis or treatment plan.
Furthermore, incomplete access can lead to:
- Confusion about diagnoses and next steps.
- Missed follow-up actions if lab results are delayed or absent.
- Difficulty interpreting medical terminology without proper context or explanation.
Patients unfamiliar with healthcare jargon may misinterpret or overlook critical information, potentially compromising their ability to participate effectively in their own care.
References
Hebda, T., & Czar, P. (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.). Boston, MA: 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