Saturday, November 16, 2013

Personal Health Records



Week 11 Assignment PHR for patients use
I started my search for information on PHRs or Personal Health Records the same way an unknowledgeable patient would.  I began with an internet search for personal health record.  Unfortunately, the results can give information pertaining to practitioner as well as patient usage.  Changing my search words several times made similar results.  All of the sites I found were mainly for practitioner or clinical use.  The few links for patients required account sign-up with credit card even to get something as simple as basic information. 
I checked http://www.myphr.com supplied by AHIMA.  Their site teaches you how to create your own PHR from scratch with a few simple directions and instructions. 
                The site Medline.com suggests checking with your Healthcare Provider, Insuring company or Employer to see if they offer PHR software or website service.  I checked with my personal insurance provider who did not offer a PHR available on the internet.  I am not employed so I could not check an employer.  I then tried my medical provider and they only offer a Patient Portal that allows you to access basic information such as appointments and privacy rights.  I will mention that the only PHR I actually have knowledge of came about by accident.  My grandmother-in-law wanted a Medicare Alert Bracelet for safety as she is very ill.  I searched for M.A. Bracelets and found one that actually includes a built in memory computer mini drive.  The drive contains software PHR that you bring up on your computer and works as a Fill-in-the-blank system.  There are places for all the expected sections of a traditional PHR, areas to add all medications, and it is easily editable.  The software on the bracelet only cost the price of the bracelet purchase (20$).  It is portable, can be kept on the person, looks exactly like a traditional metal medical alert bracelet and is easily accessible by Ipad, laptop, or computer.  This is the easiest user friendly system I found.
                Some of the problems associated with electronic PHRs are security/privacy, acceptability, and accuracy.  Records that are internet based may not be accessible in times of power outages, locations without computer access, or just not easily accessed.  Most of the commercial systems are paid for by monthly charged payments.  A missed payment might mean limited or discontinued access.  Security can be a major issue with records kept on the internet.  Security access must be kept safe from hacking and identity theft, just signing-up with a Secured site may not be enough.  Accessibility must also be made safe and maintained by both the patient and company.  This would include password security and identity checks.  Another problem is acceptability.  Will a healthcare facility or hospital even be willing to accept information contained in a PHR?  The last problem would be accuracy.  If a patient has a PHR it may not necessarily contain accurate information.  Outdated information such as incorrect medication dosages or medical conditions could cause dangerous outcomes or delay medical treatment.
                A problem with PHRs in general is that there is a lack of standards for PHRs.  As technology has begun to make EHRs more accessible to patients as PHRs there will be an increase in patient usage, as a result, the government is beginning to take notice.  CCHIT or Certification Commission for Healthcare Information Technology was founded in 2004 and has certified EHRs since 2006.  The federal government recognized CCHIT as a certifying body; it established the first comprehensive, practical definition of what is needed in EHRs.  These national efforts are expected to have a trickle-down effect on organizations attempting to provide EHRs and PHRs for patients. (Brodnik)

Brodnick:  Fundamentals of Law for Health Informatics and Information Management
               

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