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.