Make Cents of Healthcare with a PHR

by Derek Allen on 19 February 2010 4 comments

I just graduated from FSU with a Bachelor's Degree in Information Technology. During my time there, I had the opportunity to take Health Informatics taught by Ebrahim Randeree. It was an eye-opening experience that delved deep into all aspects of IT in the healthcare industry. With significant spending being put into place to help digitize healthcare, it would be beneficial to learn about the changes that could be occurring at doctor's offices and hospitals now, rather than later. The one topic that stuck out most in my mind was the Personal Health Record (PHR). The PHR gives the power to the patient, which is where it should lay within the healthcare system.

A PHR is a Personal Health Record that organizes current and past health records into a single source. It typically includes medical conditions, medication history, immunizations, and lab reports. They can become more complex and can be used to track doctor's orders, hospital stays, health progression, and consent forms. There are multiple formats in which a PHR can be maintained and shared: paper, PC software, online application, and even mobile software. A well-maintained PHR allows for individuals to become active in their healthcare and help make educated healthcare decisions.

Higher Quality Healthcare

A PHR gives you direct control over your health records, the very information used by doctors to diagnose, treat, and care for patients. It might sound cliché, but the ways a PHR can benefit your overall well-being are really limitless.

1. Validity

This is valuable by providing doctors with health information you know is valid. There are a lot of people who touch your standard health record and each point of contact is a possible error in your record. A PHR ensures that you have the control over your health record. An error in your health record could equate to a potential mistake made on wrong information.

2. Medication Records

This encompasses a complete list of medications you have been prescribed in the past, the condition in which they were prescribed before, how effective they were, and any adverse reactions.

3. Family History

This is a complete record of any significant conditions family members have been diagnosed with. It is crucial in helping doctors help make correct diagnoses.

4. Medical History

With your entire medical history located in one source, doctors have your whole medical picture. By granting your doctor access to your complete medical history you are enabling him to do his or her job better.

5. Progression

By associating dates into your PHR, you can track the progress of every facet of your health. From weight, medication, to treatments, you are allowed to track the progression of these over time.

6. Effectiveness

By continuing to monitor your health, you can track the effectiveness of treatments, medicines, and or procedures.

7. Identifying Trends

Another benefit of associating a medical history with specific dates is the discovery of trends. If health problems started occurring at a certain time period, it may be linked to a specific source. It may be stress from a new job, a pollutant in a new home, or side effects from new medication.

This just scratches the surface of the capabilities of a PHR. Each vendor's PHR will offer unique tools. Some offer the ability to receive and file prescriptions completely online. Others allow you to send requests to your doctor for refills. Some even boast the ability to sync emergency information to your iPod. As time goes on, PHR developers will realize new services and features to offer users.

Make Cents of Healthcare

While a PHR can certainly impact your health in a positive way, how does it save you money? A PHR minimizes redundant tests, prescriptions, doctor appointments, and hospital stays. It aids the doctor in diagnoses and helps him make the correct decision the first time. You will save money by avoiding these redundant healthcare procedures. The sooner you correctly identify a medical problem, the better chance you have at treating and curing it. As conditions progress, they become harder to treat and could lead to additional conditions developing from the weakening of your immune system.

ARTICLE CONTINUES BELOW

A PHR will also save time, and we all know the old adage, Time = Money. You will save time by avoiding these procedures, and less time waiting at the doctor's office. Instead of filling out a plethora of forms at your first visit to a doctor, you can share your PHR with them. However, this is dependent on each doctor's policy. Not every doctor accepts PHRs, but more and more are realizing the benefits. Check with your doctor to see if they accept them; some even host them online and offer them to their patients.

As more and more doctors embrace technology, they will transfer their paper charts over to an Electronic Health/Medical Record System (EHR/EMR). According to a 2008 survey performed by the National Center for Healthy Statistics, "38.4% doctors have reported using full or partial EMR systems." This is similar to a PHR, but it is maintained by the health care provider. A lot of doctors are already doing this and may offer capabilities for integration with a PHR. Your PHR may be able to receive prescriptions or x-ray files from your doctor's EMR. Your PHR may also be able to be automatically updated with data from your doctor's EMR after each appointment; this could include notes and orders from the doctor himself. The valuable information obtained from your doctor's existing system will increase the value and usability of your PHR.

Concerns

Unfortunately, any new technology innovation is coupled with a set of concerns. Security is at the top of the list, as with any new internet-based tool that handles sensitive data. Just as when online banking was emerging, people were hesitant to deal with it online. Now you will be hard-pressed to find someone who doesn't.

Security is among the biggest concerns when it comes to adopting a PHR. This is rightfully so, as personal medical records are very intimate and could prove to be very expensive if compromised. The information could be valuable to a number of parties, including insurance companies, employers, drug companies, marketers, and identity thieves. PHR vendors realize this and have made integral security a primary focus in their software. Some PHRs allow the user to determine the level of access for each person the PHR is shared with. The nurse might only be able to see your basic information while your primary physician would get a lot more information.

The other chief concern relies in interoperability. Will the PHR be operable with your doctor's system? Interoperability is also among the biggest concerns of health information technology in general. Organizations like the Healthcare Information Technology Standards (HITSP) are working diligently to develop a set of standards among the public and private sectors.

At the very minimum, using a PHR will leave you with a complete health record that you can maintain and monitor. But the fact of the matter is that new legislature and funding will result in a drastic digitalization of the healthcare system. Adopting and using a PHR now will prepare you for the changes that will occur in the healthcare system which will directly impact the hospitals and doctor's office that you use.

Anyone have any questions regarding PHRs? Anyone already use a PHR and have a story they would like to share?

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19 Feb. 2010 | 11:44 AM Charlotte Prescott

I would really appreciate having these for all of my family! Between my cancer, and a child's extensive health issues, it's really hard for any of us to remember every test, diagnosis, consult, etc.

This was hit home when ER Frequent Flyer child was hospitalized recently during my chemotherapy. The Father had never had to negotiate a hospital stay before; a PHR would have been invaluable then.

Perhaps one could start a PHR at home, thus having records, results available to print & add to a patient file?

19 Feb. 2010 | 12:23 PM Derek

There are multiple formats for an electronic PHR. There are applications for stand alone use on a computer as well as online applications. A lot of insurance carriers are offering online PHRs as well as physicians. I would check with your insurance and PCP to see if they offer one. If they do not here is a website that can help choose one: http://myphr.com/index.php/start_a_phr/choose_a_phr/

I am sorry to hear about unfortunate medical events. I understand how a PHR can be extremely helpful in your situation. If you need any help at all please let me know and I will do my best to assist.

22 Feb. 2010 | 8:03 PM Lucille

The positive side is that doctors have more clear information at hand. One hospital & clinic group in the area has moved to completely electronic records and I can already see the benefits of the system.

The cons can be if someone puts a mistake or other bad data into the system. I had someone type an error on a medication I take and put down one of our young kids as having a history of smoking and drinking by hitting the wrong check boxes. I had a doctor a few years ago that made some rather chauvinistic and inaccurate commentary in my medical records. The copies of this doctor's records caused issue with some other doctors who assumed this guy was right. It contributed to me not getting needed medical treatment for about four years. With an electronic system controlling or removing such a thing could be harder if your records are freely passed between doctors electronically.

23 Feb. 2010 | 7:50 AM Derek

You raise very good concerns Lucille. However, errors are still prevalent, if not more so, on paper based records. While a doctor's handwriting is the butt of a lot of bad jokes, it can result in drastic mistakes because of its lack of legibility. I've had the wrong prescription given to me a few times because the pharmacy misread the doctor's handwriting.

The beauty of a PHR is that you get control of your medical records. You can check your medical record to ensure its accuracy. A doctor or nurse could misclick something in your record, human error will always be part of the equation. But with a PHR you have the opportunity to view your medical records and correct these errors.

Your medical records are also protected under HIPAA. You have the right to access and view your medical records. With a PHR this may be easy as sending an electronic request. You also have the right to make corrections to your medical records. This information may be transmitted to other doctors only to help administer care and treatment. If this happens you have the right to be notified and receive a report of everyone who has received your medical record and why.

If a doctor was using your medical record for inappropriate purposes, you may file a complaint with the state medical board. All of these complaints are public record and current and/or potential patients of said doctor may view these. If you feel your privacy rights may have been violated you may also file a complaint with the Federal Office of Civil Rights. Anyone is entitled to do this if they believe their rights have been violated.

I'm sorry to hear about how your medical records may have been abused, but they are protected under federal law. If the doctor was abusing these records, hold him accountable for his actions.