Online Journal of Rural Nursing & Health Care

My Health Companion[c]: A Low-Tech Personal Health Record Can Be an Essential Tool for Maintaining Health

My Health Companion[C]: A Low-Tech Personal Health Record Can Be an Essential Tool for Maintaining Health

Individuals can take a more active role in the management their healthcare by using personal health records (PHR), a type of documentation which allows them to access and coordinate personal health information and share it with those who need it (Moreno, Peterson, Bagchi, & Ursin, 2007). The potential impact on one's healthcare of using a PHR is reflected in the following statement of one rural woman's experience:

The [personal health record] was really a great help to me this week. I had an appointment with my medical doctor on Monday ...! had my book with medications and all in it and added the test results from this visit. For the first time I had my questions ready and noted all we discussed. I felt so empowered to be organized and prepared for once.... I love this new feeling of gaining control (Weinert, Cudney, & Kinion, 2010).

This explicit description is an example of how one rural woman used a PHR and took an active role in monitoring her health and healthcare. By sharing this record, she gave her healthcare providers a valuable insight into her personal health story and became a partner in care with her provider. This partnership is essential for individuals to receive the most effective, efficient care possible (Holman & Lorig, 2000). An important task is for the individual to assume the responsibility for keeping the PHR accurate and complete (American Health Information Management Association, 2005).

The sense of empowerment the woman felt could be attributed to her acceptance of responsibility for managing her own condition and ability to solve her own problems with information, but not orders, from her healthcare provider. Empowerment implies that the choices made in everyday living with chronic illness are informed ones, grounded in the individual's emotions, thoughts, values, goals, and other psychosocial aspects of living with a chronic condition (Funnell et al., 1991). In doing so, chronically ill individuals become experts about their own lives (Bodenheimer, Lorig, Holman, & Grumbach, 2002). Thus, personal health records combine knowledge and data which help individuals to become active participants in their own care (Tang, Ash, Bates, Overhage, & Sands, 2006).

Among the benefits of PHRs were the ability to track clients' health conditions in conjunction with their healthcare providers, and lowered communication barriers between individuals and care providers (Tang et al., 2006). The latter is a plus because the role of the healthcare provider becomes that of a teacher and partner, and the role of the individual evolves into that of a reporter of the trends and tempo of his/her health (Lorig & Holman, 2000).

A PHR includes health information managed by the individual as opposed to the clinician's record of patient encounter-related information, such as a paper chart or a computer-based patient record. Although there are not good data currently available that quantify the current use of PHR systems, Tang and colleagues (2006) believed that the majority of consumers using a PHR today use one that is integrated with the provider's electronic health record in some way.

Over time, the ultimate goal is an electronic environment in which an individual's health information can flow seamlessly among systems used by authorized health professionals and the individual, when s/he authorizes such sharing (Tang et al., 2006). Until that time, low-tech approaches to maintaining and utilizing a PHR can play an important role in maximizing the communication between individuals and health care providers.

This maximum communication is of particular importance in rural areas because accessing quality health care is impacted by scarcity of providers, limited dissemination and application of up-to-date health care information, long distances, and dangerous travel conditions. Leaving home to keep a healthcare provider appointment often involves much advance planning to cover farm or ranch responsibilities such as animal care, meal preparation for workers, etc. It is important that such an effort is not wasted by an unproductive office visit such as was reported by this rural woman:

The doctor was running behind schedule ... My appointment was at 10 a.m. and I saw him at 11:30 ... But then the doctor (who was seeing me for the first time) was in a hurry to get through my visit. So 10 minutes later I was going out the door (Weinert, Whitney, Hill, & Cudney, 2005).

Development of My Health Companion[R]

Recognizing the merits of PHRs and in response to the frustrations related to nonproductive relationships with the health care system and providers, expressed by participants in our program of rural research, a low-tech, paper/pencil personal health record, My Health Companion was developed. The development tasks, as described in detail in an earlier article (Weinert, Cudney, & Kinion, 2010) were: defining the content, establishing an appropriate reading level for the MHC[C], and planning participant orientation to the MHC[C]. The resulting MHC[C] was used in three rural research studies during which we gathered data on its use and utility.

Purpose

The purpose of this paper is to report the results of the initial evaluation of the My Health Companion[C] (MHC[C]) as evaluated in a rural environment. The questions to be answered were: How much was the MHC[C] used? Did it enhance confidence in communication with healthcare providers? Was the use of the MHC[C] helpful in achieving health maintenance activities? Would the MHC[C] be recommended for use by others?

Methods

Evaluation data were gathered from three different rural research studies that utilized three separate populations: Women to Women (WTW) Project; Enhancing Self Care (ESC); and Health Enhancement for Rural Elderly (HERE). …

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