scholarly journals A Review of the Empirical Evidence of the Healthcare Benefits of Personal Health Records

2013 ◽  
Vol 22 (01) ◽  
pp. 93-102
Author(s):  
B. Fernando ◽  
D. Kalra

Summary Objectives: This literature review sought to identify the established evidence of the health and healthcare benefits (or harms) from the use of electronic personal health records (PHRs) and PHR systems. Methods: The definition of a PHR published in ISO 14292 was used to scope this review and the search strategy. Publications were included if the introduction of a PHR was the primary intervention, and if its evaluation met one of the Cochrane EPOC Group criteria. Studies were excluded if they only reported the design or basic user acceptance of a PHR system without an assessment of its impact on individuals and/or their health care. The impacts were classified according to the six aims of 21st-century health care defined by the US Institute of Medicine. Results: Searches were conducted in PubMed in December 2012. Out of 741 papers that met our initial search criteria, 31 were retained after title and abstract screening. After full paper review 5 studies were found to report original evidence of impact. Of these, three reported beneficial impacts on effectiveness, one on patient centredness, and one study reported impact on both aims. No harmful effects were reported. Conclusions: Although this literature review did identify some evidenced benefits from the use of PHRs and systems, our main observation is that there are very few studies published that seek to formally evaluate impact. The majority of publications we screened documented designs or basic user acceptance. Further investment in evaluation is needed to inform the evolution of this field.

2014 ◽  
Author(s):  
Pierre-Cedric Crouch ◽  
Carol PhD, RN, FAAN Dawson Rose ◽  
Mallory I. Johnson ◽  
Susan Janson

Background: The HITECH Act signed into law in 2009 requires hospitals to provide patients with electronic access to their health information through an electronic personal health record (ePHR) in order to receive Medicare/Medicaid incentive payments. Little is known about who uses these systems or the impact these systems will have on patient outcomes in HIV care. The health care empowerment model provides rationale for the hypothesis that knowledge from an electronic personal health record can lead to greater patient empowerment resulting in improved outcomes. Objective: To determine the patient characteristics and patient activation, empowerment, satisfaction, knowledge of their CD4, Viral Loads, and antiretroviral medication, and medication adherence outcomes associated with electronic personal health record use in Veterans living with HIV at the San Francisco VA Medical Center. Participants: HIV-Infected Veterans receiving care in a low volume HIV-clinic at the San Francisco VA Medical Center, divided into two groups of users and non-users of electronic personal health records. Methods: In-person surveys were completed either online or on paper and data abstraction was completed from medical records for current anti-retroviral therapy (ART), CD4 count, and plasma HIV-1 viral load. Measures: The measures included the Patient Activation Measure, Health Care Empowerment Inventory, ART adherence, provider satisfaction, current CD4 count, current plasma viral load, knowledge of current ART, knowledge of CD4 counts, and knowledge of viral load. Results: In all, 40 participants were recruited. The use of electronic personal health records was associated with significantly higher levels of patient activation and levels of patient satisfaction for getting timely appointments, care, and information. ePHR was also associated with greater proportions of undetectable plasma HIV-1 viral loads, of knowledge of current CD4 count, and of knowledge of current viral load. The two groups differed by race and computer access. There was no difference in the current CD4, provider satisfaction, Health Care Empowerment Inventory score, satisfaction with provider-patient communication, satisfaction with courteous and helpful staff, knowledge of ART, or ART adherence. Conclusions: The use of electronic personal health records is associated with positive clinical and behavioral characteristics. The use of these systems may play a role in improving the health of people with HIV. Larger studies are needed to further evaluate these associations.


2014 ◽  
Author(s):  
Pierre-Cedric Crouch ◽  
Carol PhD, RN, FAAN Dawson Rose ◽  
Mallory I. Johnson ◽  
Susan Janson

Background: The HITECH Act signed into law in 2009 requires hospitals to provide patients with electronic access to their health information through an electronic personal health record (ePHR) in order to receive Medicare/Medicaid incentive payments. Little is known about who uses these systems or the impact these systems will have on patient outcomes in HIV care. The health care empowerment model provides rationale for the hypothesis that knowledge from an electronic personal health record can lead to greater patient empowerment resulting in improved outcomes. Objective: To determine the patient characteristics and patient activation, empowerment, satisfaction, knowledge of their CD4, Viral Loads, and antiretroviral medication, and medication adherence outcomes associated with electronic personal health record use in Veterans living with HIV at the San Francisco VA Medical Center. Participants: HIV-Infected Veterans receiving care in a low volume HIV-clinic at the San Francisco VA Medical Center, divided into two groups of users and non-users of electronic personal health records. Methods: In-person surveys were completed either online or on paper and data abstraction was completed from medical records for current anti-retroviral therapy (ART), CD4 count, and plasma HIV-1 viral load. Measures: The measures included the Patient Activation Measure, Health Care Empowerment Inventory, ART adherence, provider satisfaction, current CD4 count, current plasma viral load, knowledge of current ART, knowledge of CD4 counts, and knowledge of viral load. Results: In all, 40 participants were recruited. The use of electronic personal health records was associated with significantly higher levels of patient activation and levels of patient satisfaction for getting timely appointments, care, and information. ePHR was also associated with greater proportions of undetectable plasma HIV-1 viral loads, of knowledge of current CD4 count, and of knowledge of current viral load. The two groups differed by race and computer access. There was no difference in the current CD4, provider satisfaction, Health Care Empowerment Inventory score, satisfaction with provider-patient communication, satisfaction with courteous and helpful staff, knowledge of ART, or ART adherence. Conclusions: The use of electronic personal health records is associated with positive clinical and behavioral characteristics. The use of these systems may play a role in improving the health of people with HIV. Larger studies are needed to further evaluate these associations.


2014 ◽  
Vol 3 (4) ◽  
pp. 473
Author(s):  
Henry Ogoe ◽  
Odame Agyapong ◽  
Fredrick Troas Lutterodt

Individuals tend to receive medical care from different health care providers as they drift from one location to another. Oftentimes, multiple providers operate disparate systems of managing patients medical records. These disparate systems, which are unable to share and/or exchange information, have the propensity to create fragmentation of care, which poses a serious threat to the realization of continuity of care in the Ghanaian health care delivery. Continuity of care, which is the ability to seamlessly access, update, and manage patients medical information as they visit multiple providers, is a crucial component of quality of care in any health delivery system. The current system of managing patients records in Ghanapaper-basedmakes continuity of care difficult to actualize. To this end, we have developed a smartcard based personal health records system, SMART-MED, which can effectively promote continuity of care in Ghana. SMART-MED is platform-independent; it can run as standalone or configured to plug into any Java-based electronic medical record system. Results of a lab simulation test suggest that it can effectively promote continuity of care through improved data security, support interoperability for disparate systems, and seamless access and update of patients health records. Keywords: Continuity of Care, Fragmentation of Care, Interoperability, Personal Health Records, Smartcard.


Author(s):  
Simon Y. Liu,

Consumers, industry, and government have recently focused attention on the potential of personal health records to empower patients in the health care process, improve patient-provider relationships, facilitate patient access to health information, and improve the quality of health care. A Personal Health Record (PHR) is a private and secure digital record that is created, managed, and owned by an individual, and contains the owner’s relevant health information. The benefits of PHRs have not yet been widely realized due to several significant challenges in their adoption, including the need for privacy, security, and interoperability, and the lack of accepted standards. Although many players in the healthcare arena are beginning to offer partial solutions, none have adequately addressed the full range of challenges. The adoption of PHRs can be significantly accelerated by the development of Open Source software that enables an individual to collect, create, organize, and manage his or her own private and secure PHR, using a standardized format and controlled vocabulary.


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