The Invisible Work of Personal Health Information Management Among People With Multiple Chronic Conditions: Qualitative Interview Study Among Patients and Providers

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The following is a review of Ancker et al. 2015 regarding the value of patients information management within those suffering from multiple chronic conditions: [1]

Introduction/Background

Management of patient’s information across the various clinical settings represents a crucial role in the further improvement in the treatment for their condition, especially when they suffer from multiple chronic conditions (MCC). The issue of having an ineffective control in the retrieval of a patient history results in coordination issues within the clinical setting, poor quality of care, and redundant medical errors. However, the issue lies not only within the clinical management alone, but with how well the patient is able to manage its own information through his Personal Health Record (PHR). Given the following option for the patient to manage his/her own information a question arises. Where is the pitfall of the management of information? Is it due to clinical personal or the result of an inexperience user/patient? Ancker et al. 2015, explore the effectiveness of the use of “personal health information management” (PHIM) an activity viewed from a patient perspective, as the tasks involved in collecting and managing personal medical information; This study explored the use of PHIM across users suffering from MCC.

Methods

Participants were recruited from three different clinical settings:

The process of recruitment involved distribution of flyers across different clinical settings, and those involved in the study were surveyed immediately or after clinical visit. 22 patients were enrolled and 7 health care providers with a slight association within them; Patient-Provider (13/22).

Results

Results from the study revealed that there is an association with complex and changing networks of clinical settings expressed by patients suffering from MCC. Although, many of the patients expected that their PHRs information management was conducted by those in the clinical setting, many of them in reality took an extreme active role managing their records. Yet, many of these activities were performed by the driven fear from their private information been erroneously used or shared across the different clinical settings. Also, many of their actions and decisions on how to manage their information were influenced/limited by their knowledge on how the health care system worked.

Conclusion/Comments

I would criticize that their sample was limited to three urban facilities and to English speaking patients. Further inclusion criteria for the election of those three settings wasn’t provided and is an issue for the understanding of the value of the study in that specific area. Aside from these pitfalls, the study yields some interesting insights. Mainly, the recurrent fear of patients for the security and privacy of their information. Although, it is indeed an issue which we aren’t completely immune to, it is not a reason to be a factor for the increase in the activity of patients. Diseased populations with MCC should understand and further discuss the management of their information with their different health providers in order to change this effective, but erroneous way to act and manage their PHRs information.

References

  1. Ancker, J. S., Witteman, H. O., Hafeez, B., Provencher, T., Van de Graaf, M., & Wei, E. (2015). The invisible work of personal health information management among people with multiple chronic conditions: qualitative interview study among patients and providers. Journal of medical Internet research, 17(6). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526906/