Safety-net providers such as public hospitals, community health centers, and local health departments are starting to provide online tools including electronic health record (EHR) portals and personal health records (PHRs) to their patients.
These providers serve a broad range of individuals — from tech-savvy young people to patients with little knowledge of computers or access to the Internet. Nevertheless, some leading-edge providers are finding ways to help their safety-net patients gain the benefits available from online tools, including better continuity of care, more family involvement in their care, and help in managing chronic illness.
To illustrate the range of approaches that are possible, this report includes case studies of several early-adopters:
- Cambridge Health Alliance, a public safety-net provider serving seven communities outside Boston (MyChart patient portal);
- Primary Care Information Project, New York City Department of Health and Mental Hygiene (eClinicalWorks patient portal);
- Institute for Family Health, New York (MyChart-MyHealth patient portal); and
- University of California, San Francisco HIV/AIDS Program, San Francisco General Hospital (myHERO personal health record).
Programs that provide online tools to migrant workers and homeless people are also described. The lessons gleaned from early adopters focus on understanding patients' needs and capacities; making tools useful; providing training and assistance; recognizing privacy concerns; overcoming organizational barriers; demonstrating impact; and facilitating collaboration with other safety-net providers.
The complete report is available under Document Downloads.