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From Wikipedia, the free encyclopedia

A personal health record or PHR is typically a health record that is initiated and maintained by an individual. An ideal PHR would provide a complete and accurate summary of the health and medical history of an individual by gathering data from many sources and making this information accessible online to anyone who has the necessary electronic credentials to view the information.

Contents 1 Definition 2 PHR Platforms 3 Sponsors of PHRs 4 Research on PHRs 5 See also 6 Bibliography 7 References 8 External links

[edit] Definition

The term “personal health record” is not new. The earliest, English-language article indexed by PubMed that mentions the term is dated June 1978;^[1] however, search results from PubMed also reveal that most scientific articles written about PHRs have been published since 2000.

The PHR is an ill-defined concept that has been developing over several years.The term has been applied to both paper-based and computerized systems; however, current usage usually implies an electronic resource. In recent years, several formal definitions of the term have been proposed by various organizations.^{[2] [3] [4]} Although each definition is unique, most of the definitions agree that the PHR is a computerized application that stores an individual's personal health information.

It is important to note that PHRs are not the same as EHRs (electronic health records). The latter are software systems designed for use by health care providers. Like the data recorded in paper-based medical records, the data in EHRs are legally mandated notes on the care provided by clinicians to patients. There is no legal mandate that compels a consumer or patient to store her personal health information in a PHR.

PHRs can contain a diverse range of data but usually include information about:

• allergies and adverse drug reactions,
• medications (including dose and how often taken) including over the counter medications and herbal remedies,
• illnesses and hospitalizations,
• surgeries and other procedures,
• vaccinations,
• laboratory test results,
• and family history.

In addition to storing an individual's personal health information, some PHRs provide added-value services such as drug-drug interaction checking or electronic messaging between patients and providers.

[edit] PHR Platforms

One of the principle distinguishing features of a PHR is the platform by which it is delivered. The types of platforms include: paper, personal computers, the internet, and portable devices.

Paper-based PHRs: Personal health information is recorded and stored in paper format. Printed laboratory reports, copies of clinic notes, and health histories created by the individual may be parts of a paper-based PHR. This method is low cost, reliable, and accessible without the need for a computer or any other hardware.

Paper-based PHRs may be difficult to locate, update, and share with others. Paper-based PHRs are subject to physical loss and damage, such as can occur during a natural disaster. Paper records can also be printed from most electronic PHRs.

PC-Based PHR: Personal health information is recorded and stored in personal computer-based software that may have the capability to print, backup, encrypt, and import data from other sources such as a hospital laboratory. The most basic form of a PC-based PHR would be a health history created in a word-processing program. The health history created in this way can be printed, copied, and shared with anyone with a compatible word processor.

PHR software can provide more sophisticated features such as data encryption, data importation, and data sharing with health care providers. Some PHR products allow the copying of health records to a mass-storage device such as a CD-ROM, DVD, smart card, or USB flash drive.

PC-based PHRs are subject to physical loss and damage of the personal computer and the data that it contains. PC-based PHRs may be vulnerable to unauthorized access via Internet or other data connections. The encryption of personal health information is a valuable feature, as is a firewall.

Internet-Based PHR: Personal health information is accessed and edited via a Web browser. The data is stored on a remote server. Internet-based PHRs may have the capability to print information, backup data, import data from other information systems, and share information with health care providers.

Internet-based PHRs are subject to physical loss and damage of the Web server. Internet-based PHRs may be vulnerable to unauthorized access via Internet or other data connections. Internet-based PHRs have the advantage of being accessible from any location with an Internet connection with a suitable Web browser.

Mobile SmartPhone-based PHR: Personal health information is recorded and stored in personal mobile Smart Phone-based application that may have the capability to print, backup, encrypt, and import data from other sources such as a laboratory, clinics Electronic Health Record or Web based PHRs. Health history such as medications, immunizations and allergies may be stored in the application.

Portable-Storage PHR: Personal health information is recorded and stored on a portable-storage device such as a CDROM, DVD, smart card, or USB flash drive and SmartPhones such as the iPhone or Android Phone. Some portable-storage PHRs provide features such as history editing, data encryption, data importation, and data sharing with health care providers.

Portable-storage PHRs are subject to physical loss and damage of the storage device. One of the disadvantages of portable-storage PHRs is that many computers at physician offices and hospitals cannot read and update these PHRs.However,the new generation portable personal health record manager can be used as a free standing application without the need for specialized software.

[edit] Sponsors of PHRs

PHR programs are structured in the same basic way a consumer credit report is structured, in that consumers may obtain a PHR from various sponsoring organizations. Some PHRs are marketed directly to the consumer by the product vendor. The direct-to-consumer PHRs often require the consumer to pay a fee for registering a new account. Other PHRs are offered by health care organizations such as hospitals. Frequently, these hospital-based PHRs are integrated with other information systems owned by the health care delivery organization such as its EHR or laboratory information systems. Recently, PHRs are being offered to people by employers and health insurance companies, however it is unclear if the PHR is transportable or transferable if a person switches jobs or insurance companies.

[edit] Research on PHRs

Numerous articles have been published in the health literature about personal health records; however, few of these articles describe studies that evaluated the benefits of PHRs. Thus, little evidence currently exists to verify the benefits of PHRs.^[5]

[edit] See also

• Health care
• Health informatics
• electronic health record

[edit] Bibliography

Books

1. Agarwal R, Angst CM. Technology-enabled transformations in U.S. health care: early findings on personal health records and individual use,” In Galletta G, Zhang P, (Eds.), Human-Computer Interaction and Management Information Systems: Applications (Vol. 5). Armonk, NY: M.E. Sharpe, Inc., pp. 357-378. 2006.
2. Lewis D, Eysenbach G, Kukafka R, Stavri PZ, Jimison H. Consumer health informatics: informing consumers and improving health care. New York: Springer. 2005.

Journal Articles

1. "Computerisation of personal health records". Health visitor 51 (6): 227. Jun 1978. PMID 248054. 
2. "Recordkeeping systems: personal health records". J Am Med Rec Assoc. 55 (12): 42. Dec 1984. PMID 10310901. 
3. "Concepts of the Health Vault". http://www.munnecke.com/papers/D03.doc.  1999 Paper by Tom Munnecke describing an architecture for the Personal Health Record
4. "[Personal medical records and identification card, synchronized information systems]" (in French). Rev Infirm. (106): 45–6. Dec 2004. PMID 15672518. 
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6. "Report on attitudes about personal health records". Internet Healthc Strateg. 6 (9): 10–1. Sep 2004. PMID 15526437. 
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100. Winkelman WJ, Leonard KJ, Rossos PG (May-Jun 2005). "Patient-perceived usefulness of online electronic medical records: employing grounded theory in the development of information and communication technologies for use by patients living with chronic illness". J Am Med Inform Assoc. 12 (3): 306–14. doi:10.1197/jamia.M1712. PMID 15684128. 
101. Wright A, Sittig DF (Feb 2007). "Security threat posed by USB-based personal health records". Ann Intern Med. 146 (4): 314–5. PMID 17310061. 
102. Wolter J, Friedman B (Nov-Dec 2005). "Health records for the people. Touting the benefits of the consumer-based personal health record". J Ahima. 76 (10): 28–32, quiz 35–6. PMID 16333941. 
103. Woolf SH, Krist AH, Johnson RE, et al (Mar-Apr 2006). "A practice-sponsored Web site to help patients pursue healthy behaviors: an ACORN study". Ann Fam Med. 4 (2): 148–52. doi:10.1370/afm.522. PMID 16569718. 
104. Wright A, Sittig DF (2007). "Encryption characteristics of two USB-based personal health record devices". J Am Med Inform Assoc. 14 (4): 397–9. doi:10.1197/jamia.M2352. PMID 17460132. 
105. Wright A, Sittig DF (Feb 2007). "Security threat posed by USB-based personal health records". Ann Intern Med. 146 (4): 314–5. PMID 17310061. 
106. Zeng-Treitler Q, Kim H, Goryachev S, Keselman A, Slaughter L, Smith CA (2007). "Text characteristics of clinical reports and their implications for the readability of personal health records". Stud Health Technol Inform. 129 (Pt 2): 1117–21. PMID 17911889. http://booksonline.iospress.nl/Extern/EnterMedLine.aspx?ISSN=0926-9630&Volume=129&SPage=1117. 

Conference Proceedings

1. Angst CM, Agarwal, R, Downing, J. An empirical examination of the importance of defining the PHR for research and for practice,” Proceedings of the 41st Annual Hawaii International Conference on System Sciences. Jan 2008.
2. Cimino JJ, Li J, Mendoca EA, Sengupta S, Patel VL, Kuhniruk AW. An evaluation of patient access to their electronic medical records via the World Wide Web. AMIA Symposium. Sep 2000.
3. Dorr D, Bonner LM, Cohen AN, et al (2007). "Informatics systems to promote improved care for chronic illness: a literature review". J Am Med Inform Assoc. 14 (2): 156–63. doi:10.1197/jamia.M2255. PMID 17213491. 
4. Iakovidis I. From electronic medical record to personal health records: present situation and trends in European Union in the area of electronic healthcare records. Medinfo. Sep 1998. 9(1 suppl); 18-22.
5. Ross S, Lin CT (2003). "A randomized controlled trial of a patient-accessible electronic medical record". AMIA Annu Symp Proc.: 990. PMID 14728493. 
6. Stroetmann KA, Pieper M, Stroetmann VN. Understanding patients: participatory approaches for the user evaluation of vital data presentation. ACM Conference on Universal Usability; Proceedings of the 2003 Conference on Universal Usability . Nov 2003. 93-97.
7. Wuerdeman L, Volk L, Pizziferri L, et al (2005). "How accurate is information that patients contribute to their Electronic Health Record?". AMIA Annu Symp Proc.: 834–8. PMID 16779157. 

Other

1. America’s Health Insurance Plans. Consumer and provider focus groups on PHR. Unpublished. Jan 2005.
2. Angst CM, Agarwal R, Downing J. An empirical examination of the importance of defining the PHR for research and for practice. Robert H. Smith School Research Paper. May 2006. RHS-06-011.
3. California Health Care Foundation. National consumer health privacy survey 2005. Nov 2005.
4. Canedy JT. SimplyWell PHR. AHIC Consumer Empowerment Workgroup Meeting 7/23/06. Jul 2006.
5. Connecting for Health. Americans want benefits of personal health records Jun 2003.
6. Connecting for Health. The personal health working group. Jul 2003.
7. Connecting for Health. Connecting Americans to their Healthcare final report: working group on policies for electronic information sharing between doctors and patients. Jul 2004.
8. Connecting for Health. Connecting Americans to Their Health Care: A Common Framework for Networked Personal Health Information. Dec 2006.
9. Department of Health and Human Services. Standards for privacy of individually identifiable health information. Federal Register. Dec 2000. Billing Code 4150-05M; 82461-82829 (45 CFR Parts 160-164).
10. Detmer D, Steen E. Learning from abroad: lessons and questions on personal health records for national policy. AARP. Mar 2006.
11. Haslmaier EF. Health care information technology – getting the policy right. Web Memo – Heritage Foundation. Jun 2006. No. 1131.
12. Markle Foundation. Attitudes of Americans regarding personal health records and nationwide electronic health information exchange: key findings from two surveys of Americans. Oct 2005.
13. Miller RH, Sim I. Physicians' use of electronic medical records: barriers and solutions. California HealthCare Foundation. Mar 2004. 116-126.
14. Skewes JL. Shared Health, Inc. AHIC Consumer Empowerment Workgroup Meeting 7/23/06. Jul 2006.
15. Taylor H. Two in five adults keep personal or family health records and almost everybody think this is a good idea. Harris Interactive. Aug 2004.

[edit] References

[edit] External links

• Video Interview of MIT Professor Peter Szolovitz about early developments of the Personal Health Record