In what other ways can consumer-driven technology, such as the iPhone app, be used in long-term care planning to support a healthy lifestyle or manage health conditions?

Chapter 10: Long-Term Care Services

Long-term care planning is a critical component and building block for the delivery of health services. Measuring the cost-benefits of health information systems and technology and their effects on outcomes of long-term care is essential to the viability and sustainability of the health system. The components of long-term care planning include skilled nursing facilities, home health care, and mental health centers (American Recovery and Reinvestment Act, 2009). The use of advanced computer information systems (CIS) to support long-term care planning requires a redesigning of care delivery systems and the integration of technology into the way clinicians practice medicine.

Introduction

Physicians and nurses influence patient behavior that can potentially result in improved health outcomes. Introducing patient-centered health records (PHRs) to patients continues in this same tradition by providing self-management tools. Furthermore, PHRs also lead to improved communication with care team members and elucidate a higher level of patient interaction (Weitzman, 2012). For example, PHRs are beneficial for patients with chronic illnesses by enabling both the patient and physician to monitor a disease or to prompt earlier intervention (Wager, 2013).

Case Report

Apple recently entered the PHR market by configuring its popular Health app to allow individuals to access their electronic health records, potentially revolutionizing how consumers manage personal health information from multiple healthcare providers. With their health records at their fingertips, patients with this app become active participants in their long-term care planning and delivery (Krist et al., 2014). Both patients and providers can use PHR data for analyzing, monitoring, and planning health interventions and initiatives (Weitzman, Kelemen, Kad, & Mandl, 2012). Medical care team members can utilize current and accurate patient-maintained health data that are reliable and valid for chronic disease management. By integrating PHRs into long-term care planning, patients are actively engaged to significantly participate in prevention or intervention to improve health outcomes. For example, Jones, Shipman, Plaut, and Selden (2010) emphasized that widespread robust PHR usage will result in higher patient engagement and improve the quality and delivery of health services. But improving health outcomes are just the beginning of why patients ought to record and update their personal health information in an electronic format. For example, Apple’s PHR pilot involved working directly with various health systems across the United States and ensuring that national standards for interoperability in data sharing with major EHR systems was achieved (Spitzer, 2018).

Discussion

The health information for patients with chronic conditions often has gaps; medical records often are siloed and difficult to access, leaving room for a lack of continuity in the health information for a given patient (Pai, Lau, Barnett, & Jones, 2013). PHRs allow patients to be the mediators of their own health information. Patient populations with multiple chronic conditions that require ongoing planning and monitoring are ideal participants to use PHR for long-term care planning (Krist et al., 2014; Pai et al., 2013). Encouraging patients to both manage and maintain the PHR ensures that reliable health data are available for long-term care planning. Introducing patients to PHRs early in the planning process can help them self-manage and follow through on the long-term care plan. However, there are challenges with the use of PHRs. For example, 50.6% of participants in a recent survey failed to adopt PHRs because they were unfamiliar with the technology; older patients with more chronic conditions who may need the app the most are also typically the least literate in mobile technologies (Donohue-Koeniger et al., 2014). Additionally, hospitals and health systems will likely be slow to adopt use of the apps, so using them in a meaningful way is years down the line. 

References

American Recovery and Reinvestment Act. (2009). P.L. 111-5, as signed by President Barack Obama on February 17, 2009.

Donohue-Koeniger, R., Kumar Agarwal, N., Hawkins, J. W., & Stowell, S. (2014). Role of nurse practitioners in encouraging use of personal health records. Nurse Practitioner, 39(7), 1–8.

Jones, D. A., Shipman, J. P., Plaut, D. A., & Selden, C. R. (2010). Characteristics of personal health records: Findings of the Medical Library Association/National Library of Medicine Joint Electronic Personal Health Record Task Force. Journal of the Medical Library Association, 98(3), 243–249.

Krist, A. H., Woolf, S. H., Bello, G. A., Sabo, R. T., Longo, D. R., Kashiri, P., . . . Cohn, J. (2014). Engaging primary care patients to use a patient-centered personal health record. Annals of Family Medicine, 12(5), 418–426.

Pai, H. H., Lau, F. F., Barnett, J. J., & Jones, S. S. (2013). Meeting the health information needs of prostate cancer patients using personal health records. Current Oncology, 20(6), e561–e569. http://dx.doi.org/doi:10.3747/co.20.1584

Spitzer, J. (2018, March 29). Apple’s health records beta feature now available at 39 health systems. Becker’s Health IT & CIO Report. Retrieved from www.beckershospitalreview.com/healthcare-information-technology/apple-s-health-records-beta-feature-now-available-at-39-health-systems.html

Wager, K. A., Lee, F. W., & Glaser, J. P. (2013). Health care information systems: A practical approach for health care management. (3rd ed.). San Francisco, CA: Jossey-Bass. 

Questions

1. The COVID-19 pandemic has increased the need for long-term care planning, especially in nursing facilities. How can PHRs be successfully implemented into more nursing facilities to help improve patient health outcomes? Please provide a specific example.

2. In what other ways can consumer-driven technology, such as the iPhone app, be used in long-term care planning to support a healthy lifestyle or manage health conditions?

3. Although the use of PHRs have many advantages, what are some disadvantages to using PHRs in long-term care planning? What are some possible solutions?