Impact of Health Literacy on Patients Decision to Adopt Health Record Discussion


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Discussion Question:
Visit the National Center for Biotechnology Information (NCBI) website and read the article “The Impact of Health Literacy on a Patient’s Decision to Adopt a Personal Health Record.” Provide a summary of your findings and any insights you have gained in the review of the information.

Please review the Download Discussion Case Study Assignment Instructions prior to posting. You may also click the three dots in the upper corner to Show Rubric.

Discussion: Case Study – Participatory Healthcare Informatics Resources

The Impact of Health Literacy on a Patient’s Decision to Adopt a Personal Health Record

NOTE: Each reply must be at least 450 words. Each thread and reply must include at least 1 biblical integration and 2 peer-reviewed source citations in current APA format in addition to the textbooks.

1. Classmates Post

Meaningful Use requirements, like the utilization of patient portals, and HIPAA grants the patient the ability to securely access their health information and encourages patient engagement (Easterling, 2021). The patient portal allows individuals to access their health information and clinical data, but also allows communication between that patient and their provider. Beyond using the portal, patients can become proactive with their health by adopting a personal health record (PHR). The PHR is kept and maintained by the patient and includes a range of health information. The likelihood of patients adopting PHRs was studied with the hypothesis that demographics and health literacy influenced intentions to use a PHR (Noblin, Wan, & Fottler, 2012). The results showed demographics had no significant impact on PHR adoption, but patients with high health literacy were more apt to start a PHR (Noblin et al., 2012). Providers and care teams should have a plan and tools to properly educate patients regardless of demographics. Understanding different levels of comprehension can better orient providers to what tools a patient may need to grasp the importance and benefits of engaging in their health (Noblin et al., 2012). One tool the discussion mentioned was the “infobutton.” I thought this was pretty similar to the interactive personal (preventative) health record (IPHR) that our text mentioned. The IPHR brings together information from the EHR and simplifies it for easy understanding. Instead of being only used for Pap smears, it is using all patient EHR information. It provides evidence-based suggestions for prevention so that a patient can make informed decisions (Krist et al., 2012). While the study on IPHRs was also conducted in 2012, I think more people would likely use this service than a PHR simply because it is easier to understand and is less work for the patient to put information together. Both tools are great for patient activation and engagement, but they require patient acceptance, training, and education for them to be effectively used.

The healthcare provider was a highly impactful part of the study. I found it interesting that the communication and attitude of the provider were both limitations and influences on a patient adopting the PHR. Similarly, the attitude and intentions of the patient also affected their decision. The influence of the provider and the motivation of the patient, based on the theory of reasoned action, increases the likelihood of the behavior, using PHRs, occurring. Patients indicated that clinician endorsement/recommendations would be primary motivators for using PHRs (Nazi, 2013). Conveying the benefits, providing education, and being proactive with the patient can encourage patient efforts (Nazi, 2013). If the provider has a positive outlook on PHRs and can translate it to the patient, the patient is more likely to be onboard. The patient-provider communication ties all motivators together. The management of the PHR with the ability to communicate with the provider for assistance empowers the patient to control their health and coordinate effectively with the healthcare team.

With technology being heavily integrated with healthcare, a patient’s “connectedness” needs to be acknowledged and considered. The questions in the study were about using the internet and the comfortability of connecting information to personal health. Since 2012, the use of technology has significantly increased, but PHR usage does not seem to be keeping up. People may be comfortable using technology, but getting educated on using technology to better personal health is lacking. Elizabeth Glowacki (2016) looked at how language and the delivery of information can elicit different reactions. Clearly how a provider shares information about the PHR influences how likely a patient is to use one, but emphasizing what a PHR can do for the patient can influence discussions and motivation to use one (Glowacki, 2016). It is changing the narrative from the patient facilitating communication to a provider through the PHR to the PHR being the link between the two and a “catalyst for better health outcomes” (Glowacki, 2016). Glowacki concluded that when a linguistic agency was assigned to a PHR, patients supported the recommendation that every patient should have one and felt more comfortable using one (Glowacki, 2016). Changing the way we integrate technology and how we communicate makes a significant difference in the healthcare system.

How a patient is educated, the attitude of the provider and patient, and how well a patient can connect information on the internet are factors that affect the adoption of PHRs. Colossians 4:6 says, “Let your speech always be gracious, seasoned with salt, so that you know how you should respond to each one” (St. Joseph Medium Size Edition of the New American Bible, 1970). However we communicate, it should always be kind. We may not always have the right answers, but we can learn and be educated to be better.


Easterling. (2021). Healthcare Informatics (1st ed.). New York, NY: McGraw Hill.

Glowacki. (2016). Prompting participation in health: Fostering favorable attitudes toward personal health records through message design. Patient Education and Counseling., 99(3), 470–479.

Krist, A. H., Woolf, S. H., Rothemich, S. F., Johnson, R. E., Peele, J. E., Cunningham, T. D., Longo, D. R., Bello, G. A., & Matzke, G. R. (2012). Interactive preventive health record to enhance delivery of recommended care: a randomized trial. Annals of family medicine, 10(4), 312–319.

Nazi, K. M. (2013). The personal health record paradox: Health care professionals’ perspectives and the information ecology of personal health record systems in organizational and clinical settings. Journal of Medical Internet Research, 15(4), e70-e70.

Noblin, A. M., Wan, T. T., & Fottler, M. (2012). The impact of health literacy on a patient’s decision to adopt a personal health record. Perspectives in health information management, 9(Fall), 1–13.

St. Joseph Medium Size Edition of the New American Bible. (1970). New York: Catholic Book Pub

2. Classmates Post

The article that we read for this discussion board, “The Impact of Health Literacy on a Patient’s Decision to Adopt a Personal Health Record”, defined a personal health record as “an electronic, lifelong resource of health information needed by individuals to make health decisions” (Noblin et al., 2012). As physicians begin to adopt electronic health records in their practices, the implementation of personal health records is becoming more popular. Allowing patients to become more engaged in their health care, as well as improving communication between the patient and the physician are some of the benefits that have been produced as a result of personal health records (Noblin et al., 2012). Another key term that this article explains is health literacy, which is defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Noblin et al., 2012). Low health literacy can lead to poor health-related outcomes such as more frequent hospitalizations and higher use of emergency rooms. Some indicators of low health literacy are a decline in mental capacity and education that does not exceed high school (Noblin et al., 2012).

This article discussed observations centering around two hypotheses. The first hypothesis was that patients who are younger, more educated, and have higher incomes are more willing to adopt the personal health record than those who are older, less educated, and have a lower income. The second hypothesis studied was patients who have high levels of e-health literacy are more willing to adopt the personal health record than those with low levels of e-health literacy (Noblin et al., 2012).

The study conducted in this article was a cross-sectional study of patients’ intentions on using a personal health record and how that might be associated with health literacy, income, education, and age. Participants were gathered using a convenience sample from a family practice physician and four internal medicine physicians (Noblin et al., 2012). The patient’s use of technological skills was not directly assessed, but the patient was asked to provide answers to skills-based questions. In total, 562 patients participated in this study, which represented 14% of the practice’s population. Of these 562 patients, 74% indicated that they would be willing to adopt the personal health record (Noblin et al., 2012) The most common demographics that were represented in this study were the age range 41-55 years, those with a high school education or less, and those in the lowest income category. Of these categories, each demonstrated at least 71% willingness to adopt a personal health record (Noblin et al., 2012).

This study found that hypothesis one was not supported because none of the factors studied were found to be significantly different when compared to patient willingness to adopt a personal health record. However, the second hypothesis was supported by this study because the e-health literacy questions were found to be significant (Noblin et al., 2012).

After reading this article, I found a review that covered other studies on the same topic. This review found that personal health records are more likely to favor technical and health literate users, not disadvantaged patients (Showell, 2017). After screening multiple databases, 395 items were retrieved, which together compiled a list of twenty-one barriers to patient adoption of personal health records. This review was then able to categorize each of these barriers into individual, demographic, capability, health-related, personal health record-related, and attitudinal factors (Showell, 2017). This article review was helpful in creating a list of potential barriers that might have to be faced when a practice adopts a personal health record system but states that further research needs to be conducted in order to provide insight into the effects of these barriers during personal health record implementation and use (Showell, 2017).

1 Thessalonians 5:18 says, “Give thanks in all circumstance, for this is the will of God in Christ Jesus for you” (ESV). I choose this verse because this article discussed many barriers that patients may have in their life that prevent them from feeling comfortable with the idea of using a personal health record. Though we all have barriers in our life that may keep us from doing something, we should always give thanks to God for what we have.


Noblin, A. M., Wan, T. T., & Fottler, M. (2012). The impact of health literacy on a patient’s decision to adopt a personal health record. Perspectives in health information management, 9(Fall), 1–13.

Showell (2017), Barriers to the use of personal health records by patients: a structured review. PeerJ 5:e3268; DOI 10.7717/peerj.3268

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