PHRs: Worth the Effort

Carrie Vaughan, for HealthLeaders Magazine , August 12, 2009
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Will personal health records be a temporary fix or are they here for the long haul? No one knows, but some providers say the benefits for patients are worth the effort.

Personal health records alone are not going to fix healthcare. But failing to incorporate them in your organization's strategy is shortsighted, especially in light of the Health Information Technology Policy Committee's recommendations for "meaningful use" that include patient access to PHRs by 2013. Still there are a host of questions surrounding the effectiveness of PHRs, their adoption rate, and their position in healthcare reform. But industry experts agree that offering patients some sort of tool to manage their healthcare is quantifiably better than the mishmash of records they have right now.

Ernie Hood, vice president and chief information officer at Group Health Cooperative in Seattle, does not believe that personal health records offer the optimal situation for caregivers to share data, but he does concede that providing a PHR is an improvement over the current system. "It's better to give a patient a PHR tool to share their [health] information than to leave them with nothing but incomplete paper records," he says.

And now may be the perfect time for healthcare organizations to jump into the PHR game. For an organization like Group Health, which has 600,000 members who can receive care from 900 physicians and 1,600 nurses in medical centers from Washington to Idaho, to build the interfaces for a PHR, it would have to be fairly certain that patients will use it for the investment to be worthwhile.

Historically, that has been a problem, says Hood, because providers of PHRs have been small organizations without much profile. But now that Google and Microsoft have entered the market, the outlook has changed. "They probably have more reach and it's probably easier to build interfaces," Hood says.

Better than nothing
Aurelia G. Boyer says that New York-Presbyterian Hospital decided to be an early adopter of PHRs because one of its key priorities is putting the patients' needs first, which includes giving them access to their health data. New York-Presbyterian, which is involved in a regional health information organization, also hopes that giving the patient control of the record will solve some of the privacy and consent issues that have slowed down the RHIO's effort toward interoperability, says Boyer, the 2,242-licensed-bed organization's senior vice president and CIO.

It is also likely, she says, that some component of "meaningful use"—which is part of the criteria that organizations must fulfill to receive reimbursement for health IT from the American Recovery and Reinvestment Act of 2009—will require healthcare organizations to provide this type of exchange with patients.

So in April, the hospital launched, a personal health record that uses Microsoft's HealthVault and Amalga technologies. Patients can select and store personal medical information generated during their doctor and hospital visits—such as medications, surgery reports, hospital discharge instructions, laboratory, radiology, and allergy information—into their PHR. Patients can access the data using a secure username and password with any Web-enabled device.

Boyer liked Microsoft's approach because it allows other healthcare entities to write PHR software that the patients can use.

"Their vision, and one that we share, is that there would be a community of software out there and patients can use what fits their need the best," she says. For example, diabetic patients can choose the applications that work best for them and New York-Presbyterian data can be included. "From a CIO perspective, it was a low-cost way to do it and get patients robust applications," says Boyer.

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