Electronic personal health records: an environmental scan

Abstract

<p>Electronic Personal Health Record systems ( ePHRs) are systems that support patient centred health and/or medical records in electronic form and that are accessible to patients themselves. These can help patients and their families to access informed knowledge that can assist in self management of conditions and diseases. The objective of this study is to review the literature on ePHRs and to describe the design, functionality, implementations, applications, outcomes, and the perceived and real benefits of ePHRs. The major conclusions from the study are: 1) Since primary care physicians play a key role in their patients' health, and since patient ePHRs will likely be linked in some way to their physicians' Electronic Medical Record systems (EMRs ), the key to ePHR adoption in North America is the rapid and continuing growth in physician adoption of EMRs; 2) Many ePHR systems that have been studied are physician-oriented. Thus, many have not included additional patient-oriented functionalities that are needed for maximum effectiveness. Until such ePHR systems are provided for patients, it is unlikely that tangible and/or intangible improvements in health outcomes will be demonstrated; 3) Not every consumer or patient is motivated to use an ePHR, so a low overall adoption rate is to be expected. However, ePHRs should be well designed and implemented with the involvement of the major stakeholders (consumers and their families, physicians, healthcare agencies and funding agencies), to provide a range of functionalities that will support health self management and disease prevention for patients who are motivated to use them; 4) Randomized controlled trials are needed to test assumptions about the effectiveness of ePHRs designed specifically for patient health self management in a variety of patient populations; 5) The diffusion of ePHR use to those who are genuinely motivated to adopt this type of support will be at a significant cost if it is to be done effectively. Until solid information can be collected and the future of such systems is decided, support for ePHRs will be a major public policy issue for healthcare systems administrators and funding agencies.</p>