Evaluation of the Personal Health Record Pilot for Medicare Fee-For Service Enrollees from South Carolina. Appendix 8: Discussion Guide FOR PROVIDERS


Personal Health Record (PHR) Pilot for Medicare FFS Beneficiaries



Meeting Discussion Guide —
Providers of Medicare Beneficiaries — PHR Users

OVERVIEW of MyPHRSC -5 minutes

[ALI]  We would like to show you some examples of what Medicare’s PHR, MyPHRSC, offers for beneficiaries.  At this time, please turn your attention to the WebEx presentation.  We have used made up information for a made up person so that you can see the kinds of things you might encounter using MyPHRSC.

[Give a brief review of the content of each page in screenshot packet.]

  • Group Introductions, 15 minutes

Before we begin, I’d like us all to introduce ourselves. Please tell us:

  • Your first name
  • Your medical specialty and a little about your practice

Conduct Discussion, 60 minutes

…Let’s start by talking about your overall experience
with personal health records approx 15 minutes

  1. In your opinion, what is a personal health record?
    • Who is the audience, what is the format, where is the information stored, what kinds of data does it contain, etc
    • What is the purpose?
    • How would you use a PHR?

  2. Have any of your patients indicated to you that they have used a PHR?


    [If any of the providers have patients using a PHR, ask them to describe their experiences.]

  • Roughly what percentage of your patients are using PHRs?  Do you know how long they have been using them?
  • If your patients have a personal health record, how has interaction with your patients been different because they have it?
  • What functionalities of personal health records do patients indicate they like or dislike the most?
  • What are the ages of your patients using PHRs and what types of patients do you see using and/or benefiting most e.g. seniors, those with co-morbidities, the chronically ill.

  • Have any of your patients shared with you information relevant to their healthcare that they obtained using the internet? How does this affect you or your practice? What types of information do patients share? 
    (e.g.: One patient printed articles off of PubMed which he believed served as a second opinion that his doctor’s diagnosis was wrong; another printed information about a medication they wanted to try.)

  • Have patients shared their own personal written records of historical health events with you at visits? How does this affect you or your practice? What kinds of records do patients share, and how accurate or useful is the information?

    • MyPHRSC offers a wallet card that summarizes conditions, recent visits, emergency contact information and medications.  How would it affect you or your practice if your patients carried this information to visits and shared this with you?

  • Have you ever communicated with patients through email? Some PHRs allow patients to directly contact providers by secure email.  How do you think it would affect you or your practice if this feature was available to your patients?

  • Some practices now use EMRs which give patients a view into the information through their PHRs.  For those who have EMRs in practice, how would it change things if this information was shared with patients?
    • How much clinical information do you think should be included in the PHR? Are there things in particular you would not want a patient using a PHR to have access to?

      …Now we’d like to get your perception of personal health records approx 30 minutes

  • If your patient has a PHR but your practice does not have an EMR/HER, would the PHR be useful to you?  What do you think are the most common reasons for a physician to integrate PHRs into their practice and treatment of a patient?
    • increase quality of service provided to patients
    • faster/better communication with patients
    • faster/better reporting of diagnostic tests (e.g., radiology or labs)
    • reduces physician or staff time, expense
    • reduces repeat and unnecessary tests
    • reduces medical errors
    • patient education

    [Depending on responses probe further on specific issues e.g., chronic disease management, managing medications, reducing physician/staff labor costs, facilitates medical research]

  • Personal health records have the ability to provide detailed information about diagnosis, medications, tests and other medical background.  What information in a PHR would you find most useful?
    • Are there times when you think there is too much information available to patients? 
    • What type of information should be part of a PHR?  What type of information should NOT be part of a PHR?

  • What features or functions of a PHR would be least useful for you?

  • Under what circumstances would you recommend a patient use a personal health record?

  • What are the biggest barriers to physician integrating with PHRs?

    • Lack of interoperability with EMR/EHR systems
    • Impact to your workflow or cultural change in the practice
    • Reimbursement or compensation
    • Concerns of accuracy of patient-entered information
    • Concerns of patients entering irrelevant or lengthy descriptions
    • Concerns of patient overuse or abuse of secure email privileges
    • Lack of standards
    • Lack of laws and rights dealing with privacy and confidentiality
    • Legal liability concerns
    • Reliance on propriety system
    • Lack of business case

  • Are you concerned about privacy and security issues related to using personal health records?  If so, what risks are most troubling to you? 


    • General security breaches
    • Insurers and employers learning about health problem
    • Legal liability

  • If you were to design a PHR, what would you include to make this most valuable to you and your practice? What do you think would be most valuable to providers in general?

    …Now let’s discuss some of the potential impacts of personal health records approx. 15 minutes

  • Do you think patient PHRs might change how you practice medicine?  How? 
    • Will it change the workflow process in your office?
    • Will it influence your communication/relationship with the patient?

  • What do you see as the benefits of personal health records for patients? How do PHRs change the provider relationship with patients? How do you feel about it?
    • Better relationship with provider
    • Better self-management of care
    • Improved overall health
    • Keep better track of medications

  • What kinds of PHR features or functionalities could make your interaction with patients more effective? Why?

  • Which PHR functionalities have the potential to significantly impact the health outcomes of patients if used? Why?

  • Would you consider using personal health records in your office in the future?  Why or why not?

    • What kinds of things would you use the PHR for?

  • For what reasons would you consider integrating personal health records into your practice?  What incentives would be appropriate for providers from your perspective?

    • Underwriting the cost of the technology
    • Compensation for the extended time in clinical session
  • Thank you for your participation in today’s discussion.


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