Personal health records can be 'smart tools' for patients

Personal health records (PHRs) can be better utilized to engage patients and improve patient care, according to a new report from the Robert Wood Johnson Foundation (RWJF).  

The RWJF created a program, entitled Project Health Design: Rethinking the Power and Potential of Personal Health Records, to explore whether the "vision" of PHRs could be expanded beyond merely serving as electronic copies of medical records that can be viewed online. The program provided $9.4 million in funding in two rounds for 14 different grants for programs, such as using PHRs to monitor chronic conditions, help sedentary patients be more active and help older people watch for signs of cognitive decline.

The program found the results encouraging. Patients were willing to use various technologies to record, enter and receive data, and liked having access to their records. Outcomes improved, according to RWJF. Patients' observations of daily living also appeared to be more meaningful to patients than clinical data, and that available technology could track patient progress with more specificity than physician visits.

The program also identified several challenges to this patient-centered approach to health IT, including keeping up the technology as it evolves, integrating it into people's lives, technical compatibility problems, privacy concerns and liability issues, such as the accuracy of the data. The report also found that the patient-generated information was most often incorporated into the clinical workflow by nurses, health coaches and other providers but not by physicians.

"Giving people online access to their medical information is important, but it's not enough to help them truly take charge of their health. They need smart tools that can interpret their data and provide customized feedback to guide their health decisions, day in and day out. By putting consumers at the center of the design process, we have demonstrated a powerful vision of how personal health records and new technologies can empower people to better manage their health and work together with their providers to get the care they need," RWJF President and CEO Risa Lavizzo-Mourey, M.D., said in the report.

Studies have shown that patients are becoming more amenable to online access to their records, but that providers feeling the pressure increase patient engagement to meet Meaningful Use are resorting to very basic portals that provide only limited functionality. 

The Health and Human Services Department has proposed to soften the patient engagement requirements of Meaningful Use for the next couple of years, a recommendation that has been met with mixed reviews.

To learn more:
- read the report (.pdf)