While doing some research, came across this feature article in the telehealth/med device alliance, Continua’s monthly newsletter. The article, written by arguably one of the most prolific, hyperactive and knowledgeable CIO’s in the healthcare sector, John Halamka, who also happens to be a professor at Harvard Med, provides a good introductory overview of the personal health record (PHR) market.
The article does a nice job of describing recent trends in standards development, particularly that being led by the Health Information Technology Standards Panel (HITSP). This is not too surprising as Halamka is the Chairman of HITSP.
But there are a few areas that lead the reader astray.
First, as mentioned in previous posts on this site, both Microsoft’s HealthVault and the soon to go live Dossia are not PHRs, though the article refers to them as such. Rather, these are personal health platforms (PHPs), platforms that aggregate data and serve it up into a PHR application. Conversely, they also allow the consumer to download data in their PHR to the central data repository within the platform.
Second, the article states that privacy concerns will be addressed by putting the patient in control of the care and keeping of their health record. This philosophy is an idealized one that does not reflect reality. Most consumers are quite detached from their health records, having always left that responsibility to their physicians. Consumers will need education, and lots of it, to begin to grasp how best to manage their health records. An analogy here can be easily drawn from the financial industry, which has spent years (and a lot of $$$) educating the public on how to save for retirement. Sadly, no such educational effort exists today in the healthcare sector on the scale that is required. Small organizations like Patient Privacy Rights are striving to provide such educational outreach, but far more than this will be required in the future.
Third, is a minor issue in that the article only addresses PHRs that are in some fashion hosted/delivered over the Internet. While this may be the future for PHRs, consumers today are using a wide range of tools to manage their health records.
The article concludes stating that the true barriers to PHRs are political and organizational. Yes, these are barriers but one is remiss not to also mention two other significant barriers: adoption of health IT by physicians, particularly EMR software at smaller practices, and the need for converting clinical data in EMR systems to terms a consumer will understand in their own PHR. These are not trivial issues and will take time to resolve as well.
Happy to see the Continua Alliance dedicate a feature article to this important topic. In the future, a follow-on article that goes into greater depth on the connection of home medical devices and PHRs, something Halamka only briefly addressed, would be ideal as it is the convergence of these two technologies that will redefine telehealth and in many respects future healthcare practices.
Yes, MS HealthVault is a PHP, not a PHR.
Too soon to tell about Google Health — it could wind up being a PHR and/or a PHP.
Agree Vince, that is why I purposely left them out and only mentioned HealthVault and Dossia.