We discuss the development of Your Portal - Ireland’s first personal health record in mental health services.
Five years on from the launch of Your Portal, we spoke with Frankie Prendergast, Digital Health Applications Programme Manager with St Patrick’s Mental Health Services (SPMHS), about how it began, why it matters, and how it continues to evolve based on service user needs.
Your Portal is a secure free-to-use platform that enables the sharing of information between clinicians and our service users at SPMHS on a platform. Once the service user registers for our portal, that's their portal, even after they're discharged from our services. There won't be information shared between their clinical record and the portal after they're discharged, but they can use it to record information and share information with other providers or carers or family, friends - whoever might be supporting them in their recovery journey. It is their own personal health record.
What you can see and do in Your Portal
The portal can be used to view appointment details, access appointment video links, receive notifications from care teams, complete forms, upload documents, receive letters and access other helpful resources for recovery and wellness.
How the idea for Your Portal took shape
Our vision as an organisation is human rights-based, and that includes service users having access to information. We recognised the benefits of having an electronic health record and what technology could bring to enhance and improve service users' experiences and how it can improve communication between our clinicians and service users. This vision for was embedded in our 2018-2022 strategy, Changing Minds. Changing Lives., and the Portal was developed as part of that strategy development.
From vision to reality
We started work in April 2019. The Steering Committee was represented by all departments, and there was huge input from a data protection perspective. We're sharing information - this was a new concept and the first of its kind in Ireland. While there was a lot of excitement about it, a great deal of due diligence had to be done regarding the security aspects of the portal.
Keeping your information safe
Your Portal is hosted by Patients Know Best (PKB) - one of the leading suppliers of personal health records in the United Kingdom and the Netherlands. PKB holds all data in an accredited data centre in the Netherlands, which protects information behind a secure firewall. This information is encrypted whether at rest in the portal or being sent to and from the portal. No portal information is processed outside this secure PKB infrastructure.
Adapting to a pandemic
We started the implementation in 2020 with a target for phase one to go live in Sept 2020. Due to the Covid-19 pandemic, we had to pause work on the portal to enable remote working for the organisation. Then in mid-April 2020 pivoted the portal project and delivered a revised phase one of Your Portal in June 2020.
Working hand-in-hand with clinical teams
The first engagement was with programmes that use assessment tools to measure successful outcomes. Now many clinical programmes, including our Cognitive Behavioral Therapy for Insomnia programme and the Acceptance and Commitment Therapy programme use the portal to facilitate the programmes. That's a powerful use of information sharing; it helps clinicians to inform service users, and it also helps service users understand the benefits of some of the recovery and support tools they're learning in their programme.
In November 2022, we piloted a programme to enhance inpatient care pathway information. That was a big step forward; service users could now access and contribute to their integrated care plan with their multidisciplinary team.
The weekly Views and Opinions forms for service users used to be on paper. Now, at the press of a button, nurses can send a request to the service user to complete that form.
Empowering journeys of recovery
I think from a service users' perspective that it's really important to remember that conversations are absolutely key. This isn't all about reading and digital information - the human factor and the support from another person is absolutely key to recovery and support.
What we hear from service user groups is that service users don't remember everything. Being able to look back at the information that's shared to remind them of key points of discussion or what to focus on is very helpful.
The benefit for a service user is being able to have access to self-directed information and supports within the portal Library. This empowers a service user, so they feel in charge of journeys of recovery.
Shaping the future together
Feedback from service users and staff about how they wished to use the portal helped us to significantly improve the technical capabilities. It’s no longer as clunky or adding unnecessary time to their day-to-day activities. There's another stage of transformation; we are looking at the possibilities of engaging with artificial intelligence to see what it can do to improve the system.
Pictured from left to right is Leanne Cook, Service User IT Support (SUITS) Lead Administrator with SPMHS and Frankie Prendergast, Digital Health Applications Programme Manager with SPMHS.
