Personal Health Records-Reality or Myth?
There has been a lot of talk recently about how Personal health records (PHR) are increasingly necessary in today’s climate of Electronic health records (EHR). While most participants in the healthcare delivery system understand that the move will benefit the overall picture of healthcare for the patient, there has not been the expected participation or benefits for the entire system.
In theory, having all the patient’s healthcare records in one place, available for any authorized healthcare provider to view at a moment’s notice should allow every healthcare provider to efficiently and effectively address the patient’s healthcare needs. The reality is somewhat less rosy, according to a recent report by researchers at the University of Western Ontario. In a recent study published online in Canadian Family Physician, the researchers found that the implementation and adoption of PHR’s still present many challenges --- such as integration with electronic health record (EHR) technology, burdens of cost and/or time on healthcare providers, and the actual value added to the delivery of healthcare---that need to be addressed before physicians make PHR’s a part of their practices.
Specifically, physicians questioned whether the integration of a PHR with an EHR could alter the patient-physician relationship. If patients have "full and independent access" to EHR’s, then patients would not have the medical information transmitted to them by their healthcare providers face to face.PHR’s are a vital part of the EHR incentives that are being rolled out across the country by Medicare and Medicaid providers, as directed by the Patient Protection and Affordable Care Act (PPACA), which rewards healthcare providers with monetary rewards for complying with the EHR requirements.
At first glance, EHR’s and PHR’s would seem to be the same animal, so the integration of the two should not be that difficult. But there are distinct differences between the two. Just to clarify terms: EHR‘s are records by healthcare providers intended for healthcare providers and insurance carriers, not necessarily for the patient. PHR’s are the medical records of a patient, controlled by the patient for their convenience and information. Another significant difference is that EHR’s are the healthcare provider’s property, while PHR’s generally belong to the patient and are the patient’s responsibility and property. ( And yes, I know EHR can also refer to the software platform where healthcare providers keep their medical records.)
A new concept being discussed is the UHR or "universal health record” which would be a patient-centered and patient-controlled medical record that could be shared with specific healthcare providers at the discretion the patient in support of the patient's healthcare. This project would include “open source” contributions and enhancements from developers, with particular emphasis on the patient expectation of privacy from the responsible patient who has control of the PHR.
Getting back the results of the University of Ontario study: many healthcare providers don’t really see the advantage of EHR over the traditional medical records, other than the ease of transmission of information to other doctors. I would have to agree. Other than the medium on which the records are kept there is no significant difference. The expectation that EHR’s will save billions of dollars in healthcare costs is, in my opinion, just a pipe dream. But, EHR’s are the direction that the government wants healthcare providers to take, so we may as well get on board and join the electronic age. The benefits of the ease of dissemination of healthcare records between healthcare providers and to insurance carriers should help reduce back office costs for doctors, once the conversion of records has occurred and healthcare providers get accustomed to using electronic record keeping.
Another aspect of electronic health record keeping will be the change in the interaction between healthcare providers and patients. With all theie healthcare information available to the patient, the doctor-patient relationship can go two ways. Some patients will question everything and take up a lot of the doctor’s time answering questions. Other patients will lose the one-on-one relationship with their healthcare provider because all the information they need will be contained within their healthcare records. It is up the doctor to maintain a good doctor-patient relationship in each case, keeping in mind that the patient’s best interest is always paramount.
Blog subscriptionReceive email notification when a new item is added in this blog.
Tuesday, 15 November 2011
posted by Peffer DC
I find it difficult to believe that all this information could be available to all these providers, but not readily accessible to any insurance companies, or even an employer with some contacts. And what about Group Health and Kaiser where the insurance companies, are the provider. Seems like HIPPA is largely not a reality
Tuesday, 15 November 2011
posted by Brad Erickson
An important component that is not mentioned is for sharing images. Today's method of shipping around CDs is a real problem, and image-enabled PHRs (there ARE such things) could be a great step forward.
Leave a comment
Make sure you enter the (*) required information where indicated.
Basic HTML code is allowed.