1.PHRThe Personal Health Record Jacksonville University School of Nursing Kimberlee Przybysz and Jessika ReinhardtDecember 1, 2012

2. Definition There are various definitions from multiple agencies and organizations so there is not consensus on exactly what defines a PHR. Some say it is a record of health information that only comes from the patient. Others say it is a record of health information that comes from both the patient and from health care professionals. 3. PHRs are electronic systems that allow people to record, process, and share health-relatedinformation in order to help thembetter manage their health andhealthcare (Hebda&Czar,2009). 4. What the PHR is:1. A tool to collect, track, and share information about your health.2. Info about you and your health usually compiled by you and maintained by you.3. A way for you to access certain aspects of your health info to share with whom you decide whenever and wherever you need it.4. A way to keep all your health info in one easily accessed place by computer through the internet (past versions may have been paper files or booklets).5. A way for you to be more involved in your healthcare by assisting you with decisions about your care.6. Tethered- tied to a single organization or system and may containinfo from actual visits such as lab or radiology results.OR Stand alone- Not tied to a single organization or system. Can be oninternet or smartcard, CDs, or flash drives. 5. It is not a complete medical record. It does not contain your entire EHR. It is not a replacement of a legal health recordof a provider. It does not allow for order entry or resultsmanagement by the provider. 6. On the HorizonA possible alternative in the future is anetworked PHR.This PHR would access information fromvarious sources such as variousproviders, health plans, health recordbanks, or laboratories.(Hebda&Czar,2009) 7. Common Items in a PHRName, D.O.B., Blood Type, Emergency ContactDates of previous visits or upcoming appts.Dates and results of tests and screeningsMajor and chronic illnesses and surgeriesMedication ListAllergiesFamily HistoryImmunizations 8. How can you get started with a PHR? Health CareHealth PlansProviders PrivateVendors Companies 9. Impact of the PHR on Healthcare Increased patientGets peopleinvolvement ininvolved in their care helps their ownmeet objectiveshealthcare and of Healthy Peoplein their overall2020.health. 10. PHR and Healthy People 2020Healthy People 2020 ObjectivesHC/HIT-5 Increase the proportion of persons whouse electronic personal healthmanagement tools. HC/HIT-5.1Increase the proportion of HC/HIT-5.2 persons who use the internet to Increase the proportion of keep track of personal health persons who use the internet to information, such as care communicate with their healthreceived, test results, or upcoming provider.medical appts. 11. Role of PHR in Managing Health Provide health care information to selected individuals Send email messages to providers Schedule appointments Tracking compliance with recommended screening guidelines Obtain information about disease and treatment Renew prescriptions Access self assessment tools Track insurance claims Check medical record for errors Record data from home care devices such as glucose monitors Record symptoms, observations, and responses to medications 12. Benefits of PHR Managed and controlled by the individual Helps individuals become active participants in their own care bycombining essential data, knowledge, and software tool (JAIMA, 2006). Helps maintain and promote health and wellness Can include decision support capabilities that can assist in managingchronic conditions (Gandhi, 2003). Collaborates care for the individual that receives care from multipleproviders, facilities, and pharmacies. Can help decrease health care costs and improve quality of care 13. Benefit of PHR (cont.) Can help maintain a continuous connection and improved communicationbetween the patient and provider. Can be a life saver in a medical emergency 14. Barriers to PHR Lack of awareness by consumers Not everyone has access to PHR systems, computers, or devices Reliability is limited by the individuals computer, reading, and healthliteracy Time: It takes a lot of time to gather and enter health information Individuals may not keep PHR up to date Doesnt include clinicians interpretations or reliable objective data 15. Barriers to PHR (cont) Legal concerns by providers related to treatment based on inaccuratepatient entered information Privacy and security concerns by the individual Consumers are unlikely to want PHRs that exchanges data over theinternet unless they feel confident thattheir online health information is safeand secure. 16. Privacy and SecurityOnline health services that store PHRs are not covered entities under theHealth Insurance Portability and Accountability Act of 1996 (HIPAA) and arenot subject to the Privacy Rule. HIPAA is a federal regulation which provides methods for maintaining thesafety and security of individually identifiable health information. Privacy Rule protects health information that is transmitted or maintainedin any form or media.Individual PHR vendors or online health services determine their own level ofsecurity and confidentiality and disclose that information to the consumer. Some insurance companies provide PHRs. Insurance companies ARE covered entities under HIPAA and subject to HIPAA Privacy Rule. 17. Privacy and Security (cont)Consumers are concerned with hackers and employees misusing access topatient information. There are technological interventions to improve systemsecurity (Rindfleisch, 1997) Deterrents such as audit trails that record identity, time and circumstancesof users accessing information Technological obstacles which control the ability of a user to access info,ensures users only access information they need to know. Examples areauthorization, authentication, encryption, and firewalls. System management precautions such as antivirus software 18. Selecting a PHRAccording to the Medicare and Health and Human Services(2012), in choosing the right PHR we should consider theseimportant features: Does the PHR provide proper tools for storing information about medicalconditions, procedures, allergies, medications and other personalinformation? Can information about insurance claims or medical information fromdoctors be uploaded to the PHR? Does the PHR offer the ability to print a list of medications or conditionsso it can be brought to a provider or hospital? Does the PHR provide education on key health topics? Are the features/tools in the PHR worth the costs? 19. Selecting a PHR (Cont) Does the PHR provide a tool to communicate with a providers office torequest refills for medication, ask questions or make appointments? Does the PHR provide emergency access to health information? Does the PHR have a plan for what would happen to the information if thecompany either goes out of business or merges with another company? Does the PHR have policies for privacy and security of protected healthinformation? 20. Conclusion A PHR applies health information technology to your personal life toimprove safety, reduces medical errors, reduces gaps in communicationand reduce delays in receiving proper care. PHRs give all of us, as consumers of health care, control over our ownhealth information so that we can protect and improve our own healthand wellness through health promotion and disease management PHRs are a big part of the future of healthcare and will gain more andmore popularity as people become more aware of what it can do for themand will continue to evolve as the electronic healthcare age evolves. 21. ReferencesAhima. (2012). Your privacy rights. Retrieved from http://www.myphr.com/ index.php/privacy_and_phrs/your_privacy_rights/.Ahima. (2012). What is a personal health record (PHR)? Retrieved from http:// www.myphr.com/StartaPHR/what_is_a_phr.aspx.Czar, P., & Hebda, T. (2009). Handbook of informatics for nurses & healthcare professionals. (5th ed.). Upper Saddle River, NJ:Pearson.Gandhi, TK., Weingart, SN, Borus, J., et al. (2003). Adverse drug events in ambulatory care. New England Journal of Medicine, vol 308. Retrieved from http:// www.myhealtharchive.com/m/pages/BenefitsofPHR.Health and Human Services. (2012). Medicine, learn more about personal health record. Retrieved from http://www.medicare.gov/PHR/LearnMoreAbout PHR.asp#PHRChoose. 22. References (cont)HealthyPeople. (2012). Health communication and health information technology. Retrieved from http://www.healthypeople.gov/2020/ topicsobjectives 2020/objectivelist.aspx?topicld=18.Journal of the American Medical Informatics Association. (2006). Personal healthrecords: definition, benefits, and strategies for overcoming barriers toadoption. Retrieved from http:// www.ncbi.nlm.gov/pmc/articles/PMC1447551.Medicare. (2012). Personal health records (PHRs). Retrieved from http://www. medicare. gov/manage-your-health/personal-health-records/personal- health-records.html.MedlinePlus.(2011). Personal health records. Retrieved from http:// www.nlm. nih.gov/medlineplus/personalhealthrecords.html.Rindfleisch, T.C. (1997). Privacy, information tech & health care. Retrieved fromhttp://www.dl.acm.org/citation.cfm?doid=257874.257896