Providers increasingly are considering personal health record (PHR) services as a supplement to organizing a patient's
health information as they scrutinize their health information technology to ensure compliance with electronic health record (EHR) mandates.
The U.S. military has developed MyHealtheVet, a PHR service for active personnel and veterans and their families that their caregivers can access. The PHR taps into the Military Health System's EHR system -- known as the Veterans Health Information Systems and Technology Architecture (VistA) -- and is part of an ongoing effort to engage patients in their own care.
While VistA has been around for a while, its use in conjunction with PHR services is part of a new initiative. The Veterans Affairs and Defense departments are building the Virtual Lifetime Electronic Record, a joint project to establish seamless care for military personnel from active duty through veteran status.
Fernando Rivera, director of the Washington, D.C.-based Veterans Affairs Medical Center, called PHR technology a "new frontier." The system has built-in reminders for patients, and a secure text messaging option is being piloted for communications between patients and their doctors.
Patients are empowered to take control of their own health when they can see the same information flowing from electronic records that their doctors have, according to Ross Fletcher, chief of staff for the center, who recently demonstrated VistA at the American College of Healthcare Executives' 2010 Congress for Healthcare Leadership.
Fletcher pointed to one PHR where the patient was tracking his own blood pressure and weight loss from home, in addition to receiving ongoing care at the facility. The patient made notes when his levels spiked, commenting to himself that he was eating too much salt, Fletcher said. "Once he'd scolded himself twice, he came down."
You really want your hospital to be very sensitive with your data.
Sanford "Sam" Coker, Unix clinical team lead, Weill Cornell Medical Center
Companies such as Google Inc. and Microsoft have developed PHR services as well, and some hospitals are beginning to develop interfaces so providers and patients can access information through them. PHR services could become more important as hospitals are required to develop an electronic portal so patients have timely access to their information, under proposed meaningful use criteria.
PHR services are still a new concept for hospitals, however, which typically are conservative about data storage and security, according to Sanford "Sam" Coker, Unix clinical team lead for the Weill Cornell Medical Center. The New York City-based health system has had an EHR system for three years.
Data storage is a crucial element of electronic records development, for both EHR systems and PHR services, Coker said. "You really want your hospital to be very sensitive with your data." The hospital is reviewing its systems now to ensure it will be in compliance with meaningful use mandates, and is assessing global technology standards to bring in more functions, such as cloud computing, interoperability and a PHR capability.
Weill Cornell has seen its storage needs increase 25% annually in the last three years, Coker said, and he expects this year's growth to be the same. As diagnostic images are stored electronically and all paper records are converted, hospitals will have to change how they work and how they think of storage, he said.
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