1) The term is a hold-over from the physician-centric term EMR and thereby firmly attached to that conceptual framework. But does the average consumer really need to adopt an EMR architectural construct for their PHR? Unlikely. The consumer needs their own unique and self-empowering “system” to more effectively manage their health and interact with the healthcare establishment.
2) A Personal Health Record connotates just that, a record, a file cabinet of dumb data. How useful is that? Well, some have found it useful, to say manage their medications or children’s immunization records but it is an extremely small percentage of the population. Today only about 3.5% of the US population is using a PHR. In fact, when Chilmark digs deeper into its PHR numbers we find that of that 3.5% of PHR users, a significant majority are not using simple PHRs but more complex systems or platforms that allow a user to not only view their medical records, but leverage their data, typically in an automated fashion, to advise them (making that data actionable), drive transactional processes to simplify their interaction with the healthcare system and provide guidance.
That is not to say a PHR is unimportant – far from it.
What is important is that a simple PHR (using Markle’s definition) is actually of little value to your average healthy consumer. There is simply not enough there to engage consumer, which comprises about 75-80% of the population and even among the ill, as adoption rates show, the value proposition of a PHR is typically too low to drive significant adoption.
What is working and seeing adoption at fairly high rates are Personal Health Platforms (PHPs) that leverage a consumer’s health data, be it claims, labs, demographics, etc. to take a given action. There are also those, such as Kaiser’s or Group Health’s that also combine numerous transactional processes (appt scheduling, Rx refils, eConsults, etc.) that consumers/members also find extremely valuable.
But what may become a problem in the future is that policy makers are currently advocating, within the context of “meaningful use,” that physicians offer their patients/consumers a PHR by 2013. Now what does that mean? Is it simply providing access to one’s records, a consumer-centric portal view to the EMR with no record portability? Will it be just an e-file cabinet bolted to the floor of the EMR? If so, we are left with the same problem that has plague PHRs from the beginning, no one wants a dumb file cabinet, especially one you cannot move (no portability). We liken this to a perverted form of online banking where one can go see their bank account balances, but not conduct any transactions, no online bill pay, no funds transfer, nothing.
It is indeed time to retire the PHR term and begin talking about platforms they allow one to move beyond simply looking at the latest medical records, labs or med lists, but provide them with guidance and suggested actions that they can take to better manage and improve their health and/or the health of their loved ones.
Part Two, coming tomorrow, will outline a framework for assessing the attributes of PHPs.