MyHealthAtVanderbilt: policies and procedures governing patient portal functionality

Explicit guidelines are needed to develop safe and effective patient portals. This paper proposes general principles, policies, and procedures for patient portal functionality based on MyHealthAtVanderbilt (MHAV), a robust portal for Vanderbilt University Medical Center. We describe policies and procedures designed to govern popular portal functions, address common user concerns, and support adoption. We present the results of our approach as overall and function-specific usage data. Five years after implementation, MHAV has over 129,800 users; 45% have used bi-directional messaging; 52% have viewed test results and 45% have viewed other medical record data; 30% have accessed health education materials; 39% have scheduled appointments; and 29% have managed a medical bill. Our policies and procedures have supported widespread adoption and use of MHAV. We believe other healthcare organizations could employ our general guidelines and lessons learned to facilitate portal implementation and usage.

[1]  R. Califf,et al.  Health Insurance Portability and Accountability Act (HIPAA): must there be a trade-off between privacy and quality of health care, or can we advance both? , 2003, Circulation.

[2]  David W. Bates,et al.  Opportunities to enhance patient and physician e-mail contact , 2003, Int. J. Medical Informatics.

[3]  Blackford Middleton,et al.  Design and implementation of a web-based patient portal linked to an ambulatory care electronic health record: patient gateway for diabetes collaborative care. , 2006, Diabetes technology & therapeutics.

[4]  Lynda L. McGhie,et al.  THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT , 2004 .

[5]  Vimla L. Patel,et al.  The patient clinical information system (PatCIS): technical solutions for and experience with giving patients access to their electronic medical records , 2002, Int. J. Medical Informatics.

[6]  Kenneth Mandl,et al.  Electronic Patient-Physician Communication: Problems and Promise , 1998, Annals of Internal Medicine.

[7]  Hua Xu,et al.  Data from clinical notes: a perspective on the tension between structure and flexible documentation , 2011, J. Am. Medical Informatics Assoc..

[8]  C P Waegemann IT security: developing a response to increasing risks. , 1996, International journal of bio-medical computing.

[9]  Kenneth D. Mandl,et al.  Mychildren's: Integration of a Personally Controlled Health Record with a Tethered Patient Portal for a Pediatric and Adolescent Population , 2009, AMIA.

[10]  David W. Bates,et al.  White Paper: Personal Health Records: Definitions, Benefits, and Strategies for Overcoming Barriers to Adoption , 2006, J. Am. Medical Informatics Assoc..

[11]  R Wendell Coffelt,et al.  ADOLESCENT HEALTH CARE, A PRACTICAL GUIDE , 1985 .

[12]  Susan S Woods,et al.  MyHealtheVet PHR: a description of users and patient portal use. , 2008, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[13]  Ned Calonge,et al.  Screening for testicular cancer: recommendation statement. , 2005, American family physician.

[14]  Paul C. Tang,et al.  Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care , 2008, BMC Medical Informatics Decis. Mak..

[15]  M. Välimäki,et al.  Barriers and facilitators influencing the implementation of an interactive Internet-portal application for patient education in psychiatric hospitals. , 2008, Patient education and counseling.

[16]  Steven J Katz,et al.  Bridging the electronic divide: patient and provider perspectives on e-mail communication in primary care. , 2002, The American journal of managed care.

[17]  Anne F. Kittler,et al.  Primary care physician attitudes towards using a secure web-based portal designed to facilitate electronic communication with patients. , 2004, Informatics in primary care.

[18]  Taneya Y. Koonce,et al.  Toward a more informed patient: bridging health care information through an interactive communication portal. , 2007, Journal of the Medical Library Association : JMLA.

[19]  Cornelia M. Ruland,et al.  Developing a Shared Electronic Health Record for Patients and Clinicians , 2008, MIE.

[20]  Shelagh A Mulvaney,et al.  Patient Web Portals to Improve Diabetes Outcomes: A Systematic Review , 2010, Current diabetes reports.

[21]  Charles Safran,et al.  Viewpoint Paper: Governance for Personal Health Records , 2009, J. Am. Medical Informatics Assoc..

[22]  Terhilda Garrido,et al.  Patient access to an electronic health record with secure messaging: impact on primary care utilization. , 2007, The American journal of managed care.

[23]  David Young,et al.  Research Paper: Patient Experiences and Attitudes about Access to a Patient Electronic Health Care Record and Linked Web Messaging , 2004, J. Am. Medical Informatics Assoc..

[24]  Kate Huvane Gamble Right on schedule. While there are no easy wins in IT, some say automated staff scheduling systems come close. , 2009, Healthcare informatics : the business magazine for information and communication systems.

[25]  W. Jian,et al.  Electronic health record goes personal world-wide. , 2009, Yearbook of medical informatics.

[26]  Eric M. Liederman,et al.  The impact of patient-physician Web messaging on provider productivity. , 2005, Journal of healthcare information management : JHIM.

[27]  Jason J Saleem,et al.  Implementation of health information technology in Veterans Health Administration to support transformational change: telehealth and personal health records. , 2011, Medical care.

[28]  Theodore Speroff,et al.  Behind-the-Scenes of Patient-Centered Care: Content Analysis of Electronic Messaging Among Primary Care Clinic Providers and Staff , 2007, Medical care.

[29]  Kate Huvane Gamble Is it registering? Patient portals, part II (see Financial Department for part I). , 2009, Healthcare informatics : the business magazine for information and communication systems.

[30]  Daniel Z. Sands,et al.  Experiences of Physicians Who Frequently Use E-Mail With Patients , 2003, Health communication.

[31]  David T. Stern,et al.  Research Paper: A Content Analysis of E-mail Communication between Patients and Their Providers: Patients Get the Message , 2004, J. Am. Medical Informatics Assoc..

[32]  M. Wynia,et al.  Dreams and Nightmares: Practical and Ethical Issues for Patients and Physicians Using Personal Health Records , 2010, Journal of Law, Medicine & Ethics.

[33]  Bradley Malin,et al.  A Modeling Environment for Patient Portals , 2007, AMIA.

[34]  Jeffery L. Belden,et al.  Issues and questions to consider in implementing secure electronic patient-provider web portal communications systems , 2010, Int. J. Medical Informatics.

[35]  Kenneth D Mandl,et al.  Notifying Emergency Department Patients of Negative Test Results: Pitfalls of Passive Communication , 2003, Pediatric emergency care.

[36]  Janese M. Willis,et al.  Perceptions of Medicaid Beneficiaries Regarding the Usefulness of Accessing Personal Health Information and Services through a Patient Internet Portal , 2006, AMIA.