Personal Health Records and Patient Portals
Personal Health Records (PHR) and Patient Portals are two separate and distinct entities that are often confused for the same thing. A personal health record is a tool that allows a patient to keep track of their medical history independent from any health information system that a medical institution uses. Patients are able to input and edit information like: allergies, family history, and a variety of other personal medical information. This area of electronic health is fairly new and is implemented in a very few instances. Doctors are hesitant to use information that a patient can edit because it is not verified by a medical professional. Currently the two major organizations that have launched research into personal health systems are Microsoft and Google, although Google’s initiative has been discontinued due to privacy concerns and HIPAA compliance. Their products allow users to create and store their medical data in a system that is not in any way tethered to an existing health information system. Since these products have no association with a formal EHS they act more as a user generated repository. A Patient Portal is similar to PHR’s in the regard that patients have access to their medical information except that a patient portal is tethered to an existing electronic medical record (EMR). This allows patients access to information maintained by their health providers and allows their healthcare providers to send information directly to their patients. In most cases, patient portals do not allow patients to edit the information they see in order to maintain data consistency and integrity. Some hospitals are utilizing the best of both system mentioned above. They implement a traditional PHR that is tethered to an existing health information system. The Mayo Clinic and the University of Pittsburgh are developing hybrid approaches; a traditional PHR that is connected to their health information system. This allows patients to edit and contribute to their medical record while at the same time receiving updates and information from the medical record that their doctors maintain. In many cases, patients will have multiple PHR implementations for each of the health providers that they visit. Many Chief Medical Information Officers are starting to see the benefits of a hybrid approach. Hybrid PHR systems help increase workflow efficiency while at the same time increasing patient satisfaction. The current problem in implementing these systems is lack of standardization and security. Linda Reed, Chief Information Officer of Atlantic Health said, “Everyone wants secure records, but we found that putting robust security in place frustrates account owners and seems to discourage usage.” I believe that this frustration can be eliminated or reduced if an efficient authorization access model was present in health information systems, which would still secure patient information but would make the system more dynamic and user friendly. In this paper I believe that the hybrid PHR approach can be used to help create a more secure and efficient health system. The details of the service and scope will be discussed in a later portion of the paper. Before the role that patient portals will play in the proposed solution, a discussion of electronic health records and authorization models must take place.