Difference between revisions of "PHR Update"
Ronitzusman (Talk | contribs) |
Ronitzusman (Talk | contribs) |
||
| Line 16: | Line 16: | ||
Some of the challenges commonly associated with PHRs include the following: | Some of the challenges commonly associated with PHRs include the following: | ||
| − | + | 1.Whether patients should have the ability to modify professionally sourced data.3,4,6,7,8 | |
| + | |||
The issue is one of a balance between the patient’s rights to privacy and confidentiality and the need of the providers for data integrity.1 This is a major concern with PHRs, and is one that is highly disputed. Some systems ,like Indivo, provide full privacy and security to the patient. The patient can completely control who can read, write or modify his or her records.5 In other systems, such as those used in the military health system's personal health record pilot with Microsoft HealthVault and Google Health, the issue is handled by assigning an administrative to make changes.8 | The issue is one of a balance between the patient’s rights to privacy and confidentiality and the need of the providers for data integrity.1 This is a major concern with PHRs, and is one that is highly disputed. Some systems ,like Indivo, provide full privacy and security to the patient. The patient can completely control who can read, write or modify his or her records.5 In other systems, such as those used in the military health system's personal health record pilot with Microsoft HealthVault and Google Health, the issue is handled by assigning an administrative to make changes.8 | ||
| + | |||
2.The ability of patients to withhold certain medical information from their providers (a privacy issue) may at times be in conflict with patient safety.8 | 2.The ability of patients to withhold certain medical information from their providers (a privacy issue) may at times be in conflict with patient safety.8 | ||
| + | |||
The ability of patients to determine which medical information to share with their providers may result in the providers making clinical decisions based on incomplete information, potentially causing harm to patients. This may create a conflict between the patients need to control their information and their safety.8 | The ability of patients to determine which medical information to share with their providers may result in the providers making clinical decisions based on incomplete information, potentially causing harm to patients. This may create a conflict between the patients need to control their information and their safety.8 | ||
| + | |||
3.Should providers be able to withhold extremely sensitive information from PHR, or at the very least, institute a waiting period in reporting? 8 | 3.Should providers be able to withhold extremely sensitive information from PHR, or at the very least, institute a waiting period in reporting? 8 | ||
| + | |||
Should certain sensitive information, such as lab results related to sexually transmitted diseases findings, pregnancy results, and positive cancer findings, not be released into the PHR, and instead, be reported to the patient in person?</nowiki>Other challenges commonly associated with PHRs, include the following: Should the entire Problem List be shared? 3 Should the entire Medication and Allergy Lists be shared? 3 Should all laboratory and diagnostic test results be shared with the patient? 3,9 Should clinical notes be shared with the patient? 3 Should minors be able to have their own private PHR, and should patients be able to share access to their PHR via proxies? 3,10,11 | Should certain sensitive information, such as lab results related to sexually transmitted diseases findings, pregnancy results, and positive cancer findings, not be released into the PHR, and instead, be reported to the patient in person?</nowiki>Other challenges commonly associated with PHRs, include the following: Should the entire Problem List be shared? 3 Should the entire Medication and Allergy Lists be shared? 3 Should all laboratory and diagnostic test results be shared with the patient? 3,9 Should clinical notes be shared with the patient? 3 Should minors be able to have their own private PHR, and should patients be able to share access to their PHR via proxies? 3,10,11 | ||
Revision as of 20:44, 11 August 2011
What is PHR?
A personal health record (PHR) allows individuals to electronically store and organize their personal health information. It permits the patients to take ownership over their own healthcare information, including the ability to maintain a lifelong patient history, and to retain control over the content and access of the PHR. PHR is a separate system from the electronic or paper medical-record system maintained by healthcare providers. 1-3
Concerns for the viability of PHR:
In passing The Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the American Recovery and Reinvestment Act of 2009, Congress focused on the promotion of the “meaningful use” adaptation of electronic health records (EHRs), and on health information exchange (HIE).4,5 HITECH Act of 2009 made no mention of patient health records (PHR).4,5 In 2009 AHIMA, in “AHIMA Written and Oral Testimony at the NCVHs Privacy, Confidentiality & Security Subcommittee Hearing on Personal Health Records noted that there is a real concern for the viability of PHR, and its ability to take off and continue to strive in health care due to privacy, confidentiality and security concerns.4
Benefits to patients, providers, purchasers and payers of health care from PHR include the following:
1.Patients having greater access to their own medical information, allowing them to be actively involved in the management of their disease.
2.An ongoing communication between patients and physicians, which promotes a real time response from the providers in management of acute and chronic disease.
3.Providers having greater access to data that could help them in their decision making process.
4.Patients and physicians are working together to manage patients’ illnesses, including to reduce pain, to improve functional outcome, and to promote adherence to medications.
5.Electronic communication between patients and providers free or limit telephone and face-to-face communication that at times interfere with the workflow of the providers.
6.Payers and purchasers of health care could potentially benefit from lower costs, including lower medication and chronic disease management costs.6
Some of the challenges commonly associated with PHRs include the following:
1.Whether patients should have the ability to modify professionally sourced data.3,4,6,7,8
The issue is one of a balance between the patient’s rights to privacy and confidentiality and the need of the providers for data integrity.1 This is a major concern with PHRs, and is one that is highly disputed. Some systems ,like Indivo, provide full privacy and security to the patient. The patient can completely control who can read, write or modify his or her records.5 In other systems, such as those used in the military health system's personal health record pilot with Microsoft HealthVault and Google Health, the issue is handled by assigning an administrative to make changes.8
2.The ability of patients to withhold certain medical information from their providers (a privacy issue) may at times be in conflict with patient safety.8
The ability of patients to determine which medical information to share with their providers may result in the providers making clinical decisions based on incomplete information, potentially causing harm to patients. This may create a conflict between the patients need to control their information and their safety.8
3.Should providers be able to withhold extremely sensitive information from PHR, or at the very least, institute a waiting period in reporting? 8
Should certain sensitive information, such as lab results related to sexually transmitted diseases findings, pregnancy results, and positive cancer findings, not be released into the PHR, and instead, be reported to the patient in person?</nowiki>Other challenges commonly associated with PHRs, include the following: Should the entire Problem List be shared? 3 Should the entire Medication and Allergy Lists be shared? 3 Should all laboratory and diagnostic test results be shared with the patient? 3,9 Should clinical notes be shared with the patient? 3 Should minors be able to have their own private PHR, and should patients be able to share access to their PHR via proxies? 3,10,11
References
1.Grossman JM, Zayas-Cabán T, Kemper N. Information gap: can health insurer personal health records meet patients’ and physicians’ needs? Hlth Aff 2009 Mar; 28(2):377–89.
2.Markle Foundation. Connecting For Health. Achieving election connectivity in healthcare: a preliminary roadmap from the nation’s public and private-sector healthcare leaders. [Online]. 2004 Jul [cited 2011 May 28]; Available from: URL:[1]
3.Halamka JD, Mandlb KD, Tang PC. Perspectives on informatics viewpoint paper early experiences with personal health records. JAMIA 2008;15(1):1-7.
4.Mon DT. American Health Information Management Association (AHIMA) written and oral testimony at the NCVHS Privacy, Confidentiality & Security Subcommittee Hearing on Personal Health Records. [Online]. 2009 May 20 [cited 2011 May 6]; [12 screens]. Available from: URL:[2]
5.Snyder EL, Meslar RW, Levin SJ, Phillips PT, Johnson Remotigue E, Vasich MB, et al, editors. Barbri bar review: real property. USA: Thomson; 2007.
6.Tang PC, Ash JS, Bates DB, Overhage JM, Sands DZ. Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. JAMIA 2006;13(2):121–6.
7.Simborg D. The limits of free speech: the PHR problem. JAMIA 2009 Mar;16(3):282–3.
8.Do NV, Barnhill R, Heermann-Do KA, Salzman KL, Gimbel RW. The military health system's personal health record pilot with Microsoft HealthVault and Google Health. JAMIA 2011 Feb 2;18(2):118-24.
9.Keren R, Muret-Wagstaff S, Goldmann DA, Mandl KD. Notifying emergency department patients of negative test results: pitfalls of passive communication. Pediatr Emerg Care 2003 Aug;19(4):226–30.
10.Nugent CP, Miller K, Park T, Donahue S, Soni A, Nugent D et al. Living profiles: design of a health media platform for teens with special healthcare needs.
J Biomed Informatics 2010 Oct 43(5)( 1): S9-S12.
11.Cushman R, Froomkin AM, Cava A, Abril P, Goodman Kw. Ethical, legal and social issues for personal health records and applications, J Biomed Informatics 2010 Oct; 43(5)(1):S51-S
Submitted by Ronit Zusman
