Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ. Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. J Am Med Inform Assoc. 2006 Mar-Apr; 13(2): 121-6
Personal Health Records (PHR) – Today and Future Potential
Health care is migrating to care centered on the individual, thus allowing the individual more interaction and participation in his or her health care. This opens new doors for individuals, permitting them to take a more active role in their health care. It allows individuals access to their health record, permits certain health information to be self-entered; requests prescription refills; retrieves copies of their health records; and tracks vital signs including blood sugars and pressures, weight and heart rate. Additionally, the PHR will provide access to health resources. New doors are also being opened for the health care provider, especially if the PHR is integrated with the electronic health record (EHR), enabling the provider to realize benefits in patient care. It will enable the provider to make better medical decisions in the treatment of the individual.
Today, online PHR services are being offered by many health care organizations and vendors. PHR systems range in complexity from stand-alone to full seamless integration with EHR systems. Each system has advantages and disadvantages. The stand-alone application allows for greater security but the information is not shared and it is doubtful whether individuals will be resolute in maintaining its currency. The preferred system is the integrated PHR.
A longitudinal (lifetime) health care record, containing relevant subjective and objective data from various sources including the individual and health care providers, should be established, thus providing a rich resource of useful data for the individual’s health care. While there are no standards for what data the PHR should contain, it is recommended that the data source be identified. Some suggested data types include: problem list; allergy; immunizations; medications; diagnostic test results; personal tracking of vital signs including blood sugars and pressures, weight and heart rate; and others.
For the most part, there has been some reluctance in the adoption of the PHR. One impediment for this lack of acceptance may be attributed to the costs of such systems. Deciding who should pay, the providers, individuals, or perhaps the health care payers appears unresolved. Other obstacles may include technical issues (such as interoperability - without it data cannot be shared), legal issues (including privacy and negligence), and the level of an individual’s desire to use, maintain, and authorize sharing of their PHR. Although as a concept the PHR has great potential in improving the management of health care, there remain many impediments to overcome before it is successful.
