• Electronic Health Records

Empowering patients through advanced EMR use
The role ofpatient education and health literacy in patient portals.
By Elizabeth Tomsik and Bonnie Briggs

Elizabeth Tomsik. BSPharm. PharmD. BCPS. is adverse drug reaction manager. Wolters Kluwer Heahh.

Bonnie Briggs. BSPharm. is director, product management. Wolters Kluwer Health. For more on Wolters Kluwer Health: www. rsleads.comf,303ht-205

H

ealth.c.are providers are knee deep in efforts to m~ Stage

2 meaningful-use (MU) requirements in a timely fashion. While there are many uphill battles facing providers and technology vendors alike, one notable challenge voiced acros.s the industry relates to the complexities ofsetting up patient portals. WhUe not directly required in Stage 1 MU requirements, patient portals have been identified as a natural and dfecti.ve approach for achieving a number of objectives, including providing patient access to: • Health information in a timely manner; • Clinical summaries of office visits; and • Patient-specific education resources. With Stage 2 already in motion, many industry professionals believe that patient portals will be necessary for healthcare organizations to meet requirements laid out for more active electronic e~t of patients. Speci6.cally, patients will need to be able to view, download and transmit information directly from their personal health record within an electronic health record (EHR). Patient-centered requirements are only c:x:pected to C¥palld and deepen as the industry moves into Stage 3 and beyond. Simply put, the movement is all about getting more of the health record into patients' hands and educating them for more active engagement in their care. In many ways, it's a significant power shift. Clinicians will no longer he the gatekeepers of health information. And while empowering patients is an important element of the patienH:entered care movement, the transition comes with an inherent responsibility on the part ofhealthcare organiza-tions: ensuring that appropriate resources and education tools are a:vailable to patients and support a clear understanding of all elements of care. Because clinicians tend to communicate in a language very difl.ttent than that ofpatients, a key ingredient to patient portal success will be the availability of consumer-level content, presented in an easy-to-understand way. Consider that some advanced patient portal initiatives provide access to health summaries (including procedures),
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problem lists, lab and test results, medication lists, allergy lists and immunizations. As patients are provided with direct access to all of this informacion, they must be armed with the knowledge of how to analyze and act on it.

Challenges to patient education In patient portals According to a report recently issued by the Institute of
Medicine (IOM). nearly half of American adults do not adequately understand and use written health information. Specifically. 90 million people have been classified with limited health literacy. Defined by the IOM 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," health literacy and the staggering statistics regarding limited health UU:racy have formed the basis of a nwnbe.r ofnational initiatives to improve how consumer health information is presented. As Stage 2 requirements encourage greater use of patient portals and more email communication between clinicians and patients, the barriers to proper patient education become even more pronounced. With less f.we-to-face interaction, effective patient education methods that can be achieved through verbal dialogue and teach-back methods in a cUnical setting must now be accomplished through written resources within a patient portal. Teach-back methods- where patients are able to verbally provide a detailed explanation of what they have been