Emerging Technology – Personal Health Records
April 28th, 2010 — Amistaff Staff, BlueSky, Clinical, NurseTesting
The growth of new health information technologies is spurring on a communication revolution pointed towards delivering better health care and encouraging proactive health strategies. With these developments comes a series of questions surrounding the acceptance and implementation of new technologies, which affect diverse businesses and perspectives.
Defining eHealth Terms
Headlines on the eHealth revolution contain certain building blocks that should be defined to better understand the current state of the technologies: EMR, EHR, and PHR. Pinpointing the meaning behind these three acronyms portrays how daunting the responsibility to design effect eHealth communication tools is given the array of stakeholders sharing interest in the technology’s success (patients, providers, medical practitioners, insurance carriers, policy makers).
The National Alliance for Health Information Technology offered the following definitions in Defining Key Health Information Technology Terms (2008).
EMR – Electronic Medical Record – “An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.” (Bell et al, 2008) It is important to note that information on an EMR cannot necessarily be exchanged between organizations.
EHR – Electronic Health Record – “An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization.” (Bell et al, 2008) Given the industry’s push towards nationally recognized interoperability standards, EMRs will be phased out and replaced by EHRs.
PHR – Personal Health Record – “An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.” The key difference here is the consumer, or patient, holds control over managing how the information is used and accessed. For a record to be considered a PHR, the individual must hold personal responsibility for disseminating the information.
The short of the definitions comes down to EMRs and EHRs being tools for medical providers. PHRs on the other hand focus on involving the consumer in personal health initiatives to enhance wellbeing.
Current PHR Affairs
By fostering an individual’s interaction through documenting, tracking and evaluating their health conditions a PHR can lead to better informed health care decisions, superior health status, and thus, reduced health-related costs and superior quality of care. (Bell et al, 2008) With all of these benefits, where are PHRs falling short for today’s consumer markets? Developing a widely accepted technology warranting frequent interactions from a colossal population base is challenging for any marketer. But, put the jeopardy of individuals’ lives on the line and the stakes rise to an all-time high.
Communication proves a challenge for current PHRs. Although considered an emerging technology in the United States, PHR initiatives have been implemented in other nations. The successes and failures of countries such as Englad, Germany, Canada, Denmark and Australia serve as guidelines for realization of PHRs in the US. (Deutsch et al, 2009) Kreps and Neuhauser suggested new directions in which to take PHRs nationally in their article Rethinking Communication in the e-Health Era:
- Enhance interactivity between consumer and caregiver –Medical guidance counselors should have collaborative lines of communication with which to share feelings and beliefs regarding treatment. Delivery of medical information can intimidate or discourage adoption of advice. (Neuhauser et al, 2008). Internalizing instructions occurs when recipients have an active role in the collaboration phase.
- Increase interoperability of PHRs – Being able to send and receive health records in a timely fashion is of utmost importance; however, little progress has been made to develop national standards that would enable seamless use of PHRs.
- Create dynamic and engaging communications – Capturing and holding an individual’s attention generates more challenges than ever before while crossing communication barriers such as literacy, language, culture, or disability will be no small feat. Capitalizing on the social networking frenzy may further the acceptance of the new technology.
- Cost effect design control – Creating a personalized PHR feel without the personalized web-development cost is paramount. Interpersonal approaches to past health communication outcomes have proven to be more successful than targeting the mass media. The wealth of information available on the internet for free prohibits the typical consumer from justifying the purchase of a PHR. The time docked creating or using a free PHR may even seem like to much of an investment. Therefore, cost of the systems must be kept low.
Two other barriers prohibiting the use of PHRs are privacy and security. Ethical concerns surrounding privacy or confidentiality remain a hot topic for debate. All parties interested in PHRs have legal or ethical responsibilities to keep patient information confidential. However, many PHR companies do not feel obligated to follow HIPPA Privacy regulations.
The possibilities surfacing from standardized PHRs are seemingly endless…
- Web-cam Doctor Consultations
- Electronic Prescription Approval
- Personalized, Free Health & Wellness Plans
Consumers, medical professionals, and health care organizations would benefit from the additional information gleaned from a comprehensive and well-maintained PHR. Improved patient safety and health outcomes could be the result of PHRs for business stakeholders, while patients could benefit from more comprehensive health care and possibly healthier lifestyles.
Interested in learning more?
Bell, K. & Bradford, A. (2008). Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms. Department of Health & Human Services.
Deutsch, E., Duftschmid, G. & Dorda, W. (2010). Critical Areas of National Electronic Health Record Programs – Is Our Focus Correct? International Journal of Medical Informatics (79), 211-222.
Neuhauser, L. &. Kreps, G. (2003). Rethinking Communtion in the e-Health Era. Journal of Health Psychology (8), 7-22.













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