Personal Health Records: Definitions, Benefits, and Strategies for Overcoming Barriers to Adoption
01 Mar 2006-Journal of the American Medical Informatics Association (Oxford University Press)-Vol. 13, Iss: 2, pp 121-126
TL;DR: Personal health record (PHR) systems are more than just static repositories for patient data; they combine data, knowledge, and software tools, which help patients to become active participants in their own care as discussed by the authors.
About: This article is published in Journal of the American Medical Informatics Association.The article was published on 2006-03-01 and is currently open access. It has received 1272 citations till now. The article focuses on the topics: Health informatics.
Citations
More filters
06 Feb 2020
TL;DR: A state-of-the-art overview on the use of clinical decision support systems in medicine, including the different types, current use cases with proven efficacy, common pitfalls, and potential harms, and evidence-based recommendations for minimizing risk are provided.
Abstract: Computerized clinical decision support systems, or CDSS, represent a paradigm shift in healthcare today. CDSS are used to augment clinicians in their complex decision-making processes. Since their first use in the 1980s, CDSS have seen a rapid evolution. They are now commonly administered through electronic medical records and other computerized clinical workflows, which has been facilitated by increasing global adoption of electronic medical records with advanced capabilities. Despite these advances, there remain unknowns regarding the effect CDSS have on the providers who use them, patient outcomes, and costs. There have been numerous published examples in the past decade(s) of CDSS success stories, but notable setbacks have also shown us that CDSS are not without risks. In this paper, we provide a state-of-the-art overview on the use of clinical decision support systems in medicine, including the different types, current use cases with proven efficacy, common pitfalls, and potential harms. We conclude with evidence-based recommendations for minimizing risk in CDSS design, implementation, evaluation, and maintenance.
743 citations
TL;DR: The potential to use the Blockchain technology to protect healthcare data hosted within the cloud and the practical challenges of such a proposition are described and further research is described.
Abstract: One particular trend observed in healthcare is the progressive shift of data and services to the cloud, partly due to convenience (e.g. availability of complete patient medical history in real-time) and savings (e.g. economics of healthcare data management). There are, however, limitations to using conventional cryptographic primitives and access control models to address security and privacy concerns in an increasingly cloud-based environment. In this paper, we study the potential to use the Blockchain technology to protect healthcare data hosted within the cloud. We also describe the practical challenges of such a proposition and further research that is required.
590 citations
TL;DR: It is found that, because primary care physicians play a key role in patient health, PHRs are likely to be linked to physician electronic medical record systems, so PHR adoption is dependent on growth in electronicmedical record adoption.
559 citations
TL;DR: This project suggests how patients who choose to explicitly share health data within a community may benefit from the process, helping them engage in dialogues that may inform disease self-management.
Abstract: Background: This project investigates the ways in which patients respond to the shared use of what is often considered private information: personal health data. There is a growing demand for patient access to personal health records. The predominant model for this record is a repository of all clinically relevant health information kept securely and viewed privately by patients and their health care providers. While this type of record does seem to have beneficial effects for the patient–physician relationship, the complexity and novelty of these data coupled with the lack of research in this area means the utility of personal health information for the primary stakeholders—the patients—is not well documented or understood.
Objective: PatientsLikeMe is an online community built to support information exchange between patients. The site provides customized disease-specific outcome and visualization tools to help patients understand and share information about their condition. We begin this paper by describing the components and design of the online community. We then identify and analyze how users of this platform reference personal health information within patient-to-patient dialogues.
Methods: Patients diagnosed with amyotrophic lateral sclerosis (ALS) post data on their current treatments, symptoms, and outcomes. These data are displayed graphically within personal health profiles and are reflected in composite community-level symptom and treatment reports. Users review and discuss these data within the Forum, private messaging, and comments posted on each other’s profiles. We analyzed member communications that referenced individual-level personal health data to determine how patient peers use personal health information within patient-to-patient exchanges.
Results: Qualitative analysis of a sample of 123 comments (about 2% of the total) posted within the community revealed a variety of commenting and questioning behaviors by patient members. Members referenced data to locate others with particular experiences to answer specific health-related questions, to proffer personally acquired disease-management knowledge to those most likely to benefit from it, and to foster and solidify relationships based on shared concerns.
Conclusions: Few studies examine the use of personal health information by patients themselves. This project suggests how patients who choose to explicitly share health data within a community may benefit from the process, helping them engage in dialogues that may inform disease self-management. We recommend that future designs make each patient’s health information as clear as possible, automate matching of people with similar conditions and using similar treatments, and integrate data into online platforms for health conversations. [J Med Internet Res 2008;10(3):e15]
445 citations
TL;DR: It is believed that additional PHR research can increase the likelihood that future PHR system deployments will beneficially impact healthcare costs, quality, and efficiency.
439 citations
References
More filters
TL;DR: Improving communication between outpatients and providers may help prevent adverse events related to drugs, and many are preventable or ameliorable.
Abstract: Background Adverse events related to drugs occur frequently among inpatients, and many of these events are preventable. However, few data are available on adverse drug events among outpatients. We conducted a study to determine the rates, types, severity, and preventability of such events among outpatients and to identify preventive strategies. Methods We performed a prospective cohort study, including a survey of patients and a chart review, at four adult primary care practices in Boston (two hospital-based and two community-based), involving a total of 1202 outpatients who received at least one prescription during a four-week period. Prescriptions were computerized at two of the practices and handwritten at the other two. Results Of the 661 patients who responded to the survey (response rate, 55 percent), 162 had adverse drug events (25 percent; 95 percent confidence interval, 20 to 29 percent), with a total of 181 events (27 per 100 patients). Twenty-four of the events (13 percent) were serious, 51 (28...
1,228 citations
TL;DR: In this paper, the value of electronic health care information exchange and interoperability (HIEI) between providers and independent laboratories, radiology centers, pharmacies, payers, public health departments, and other providers is assessed.
Abstract: In this paper we assess the value of electronic health care information exchange and interoperability (HIEI) between providers (hospitals and medical group practices) and independent laboratories, radiology centers, pharmacies, payers, public health departments, and other providers We have created an HIEI taxonomy and combined published evidence with expert opinion in a cost-benefit model Fully standardized HIEI could yield a net value of dollar 778 billion per year once fully implemented Nonstandardized HIEI offers smaller positive financial returns The clinical impact of HIEI for which quantitative estimates cannot yet be made would likely add further value A compelling business case exists for national implementation of fully standardized HIEI
646 citations
TL;DR: This report reviews some of the extensive literature in health literacy, much of it focused on the intersection of low literacy and the understanding of basic health care information, and describes methods for assessing health literacy as well as methods for assessing the readability of texts.
291 citations
TL;DR: Personal health records (PHRs) might allow patients and providers to develop new ways of collaborating and provide the basis for broader transformation of the health care system.
Abstract: Widespread adoption of information technology is now regarded as a pathway to improving health care and achieving the Institute of Medicine’s highly regarded six aims for redesigning care. Achievin...
240 citations
TL;DR: Few U.S. physicians use outpatient electronic health records (EHRs), although it appears that most would like to begin, and the key initial policy changes will be those addressing financial incentives and interoperability.
Abstract: Few U.S. physicians use outpatient electronic health records (EHRs), although it appears that most would like to begin. The main barriers are not technical, because adoption rates in other countries are high. The biggest barrier is reimbursement, because physicians must pay for EHRs, but most of the benefits accrue to payers and purchasers. The lack of interoperability is also pivotal. Others include capital and risk tolerance; physicians’ resistance related to time concerns, fears about privacy, system maintenance, the number of vendors in the marketplace, and the transience of vendors. The key initial policy changes will be those addressing financial incentives and interoperability.
211 citations