Electronic personal health records come of age
This is a review of Clarke JL's 2006 article, Electronic personal health records come of age. It answers the question: is a personal health record a patient portal into a healthcare providers EHR system, or more generally any consumer/patient-managed health record?
The authors give the definition: "a person-centered system designed to track and support health activities across one’s entire life experience; not limited to a single organization or provider." 
Maintenance of a personal health record on paper is a practice of long standing, and passage of Health Insurance Portability and Accountability Act (HIPAA) provided a legal basis for patients to own their information. Evolution and adoption of electronic health record systems have provided a technical premise for moving forward. Web-based PHR technology would offer the potential to engage patients, giving them access, and enabling them to make their cumulative record available to their disparate health care providers.
The consumer perspective is that PHRs could provide health care data access at all times and places. Consumer engagement in the process could potentially lead to improved health through preventive measures, early detection and overall wellness activities – induced by that engagement. The provider perspective is problematic. Providers may be slow to adopt a PHR without incentives to pay for entering patient information. General resistance to change and previous negative experience with lost investments in early EHR systems may be further deterrents. Barriers to use and dissemination include privacy issues, lack of technical proficiency among older patients, lack of computer/internet access among lower socioeconomic groups, limited health literacy and the question of whether consumers are willing to pay all or part of the cost. 
The Department of Health Policy at Jefferson Medical College (Philadelphia) hosted an international advisory board meeting on the topic of personal health records, which is the basis for this article. This meeting was enabled by non-restricted educational grant from InterComponentWare (ICW) the developer of and vendor for the LifeSensor product. LifeSensor is prominently featured in this article as “a fine example of a fully functional, globally implemented system.”
- Clarke JL, Meiris DC, Nash DB. Electronic personal health records come of age. Am J Med Qual. 2006 May-Jun;21(3 Suppl):5S-15S. http://www.ncbi.nlm.nih.gov/pubmed/16621927