Advocacy   »  About PHRs

Peoplechart: The Most Robust PHR in the Marketplace

 

"The Personal Health Record (PHR) is an Internet-based set of tools that allows people to access and coordinate their lifelong health information and make appropriate parts of it available to those who need it."

"PHRs offer an integrated and comprehensive view of health information, including information people generate themselves such as symptoms and mediation use, information from doctors such as diagnoses and test results, and information from their pharmacies and insurance companies."

The Markle Foundation

The use of PHR technology holds the key for enabling individuals to maintain a copy of their health information and share that information with their health care providers and family members however they wish, when and where needed.

The genesis of PHRs

From the mid to late 1990s, a number of Internet companies have emerged to provide health information to consumers in the form of health regimens, disease-specific content or "health diaries." In the course of this growing trend toward self-help tools and consumer activism, a number of companies introduced online forms where consumers could record their health conditions, medications and history.

These forms evolved from a bare bone profile (similar to the Patient Intake form that patients fill out on their first visit to a doctor's office) to encompass personal résumés, health journals, to in-depth health questionnaires that are targeted for disease management or for monitoring certain health condition. These are mostly web-based systems that capture information self-entered by individuals or their caregivers about patient’s health history, medications, conditions, and care. Some have capabilities to communicate (internal messaging) and save the information onto the computer hard disk or portable device such as CD-ROM. Usually, the web-based system exists separately and independently from the healthcare provider’s information systems known as Electronic Medical Record (EMR). As such, they came to be described categorically as "stand-alone" personal health records, or PHR.

The advantage is that it enables full patient control, privacy, and involvement. The challenge to a system that relies upon users to self-enter data is that it involves effort to keep updated. Many of these systems do not have the ability to electronically pull and read clinical information stored inside a healthcare provider’s electronic medical record system such as diagnostic lab results, medications, radiological images, physician observations, and discharge summaries. As such, any clinical information will be notations subject to the patient and other authorized users’ interpretation. This makes it difficult for clinicians to rely on the information from these systems to drive decisions about care.

A further addition in a growing marketplace has been the emergence of provider-based EMR systems or insurer-based claims systems that call themselves PHR. These offer more than self-entered profile forms and internal messaging system. They provide patients with a front-end portal or window into the health information stored in a healthcare provider or insurer’s information systems. These (portals) are designed and usually paid for by the healthcare providers or insurers, which means that they have the authority to determine the type and scope of information to be displayed to the patient. Often times, this means not that not all information is revealed to the patient. The benefits of tethered to the EMR system is that the clinical information from the healthcare provider is kept intact and updated. The drawback is that the information is not easily downloadable onto a portable device nor can it be easily integrated with any other system. This becomes a problem for patients when they move, change insurance, or become affiliated with a new healthcare provider. In most cases, these PHR portals do not capture information created by other healthcare providers, and with information being provider-specific, do not have complete information about the patient.

Peoplechart helps define PHRs

In 2003, Peoplechart was one of twenty working group members of the initial phase of the Markle Foundation's "Connecting For Health Initiative."

According to The Markle Foundation, one of the key attributes of a PHR is that it is governed by the patient and follows them over their lifetime — regardless of care setting, facility, or geography. However, as with any nascent product market, there is little formal definition as yet for what features or capabilities constitute a full-fledged PHR. And, with the wide range of approaches introduced by different players in the industry, there has been little push so far for consensus.

Within the world of health information technology, PHR is still viewed as an emerging concept. To help move PHR into the mainstream, Peoplechart works with a number of communities, health care providers and health research organizations to help define the role this important technology will play in peoples' lives. Peoplechart has been selected as the "intervention of choice" in a national research study to quantify the benefits of PHR on healthcare quality, costs and outcomes. Click Peoplechart Projects for more details.

Since January 2006…

The PHR marketplace has experienced significant growth. A number of firms announced their intentions to invest or enter the PHR space in early 2007:

  • Insurers (Blue Cross/Blue Shield, Aetna)
  • Employer-focused organizations (Dossia)
  • Healthcare organizations (Kaiser Permanente)
  • National government pilots (National Health Information Network)
  • Consumer Internet companies (Microsoft, Google, and Intuit)

Peoplechart remains unique in its market position of being a provider-quality PHR, to be able to offer data collection service and an organization schema that can consolidate paper records and electronically transmitted data for display in a single view.