EHRs and PHRs (October 16, 2016)

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  1. 1. Electronic Health Records & Personal Health Records . . 16 2559
  2. 2. (Electronic Health Records) (Electronic Medical Records)
  3. 3. (Medical Records)
  4. 4. ? (Medical Records) vs. (Health Records) Health Records
  5. 5. Class Discussion #1 ? ?
  6. 6. (Continuity of Care) (chronic diseases) (follow-up) (drug allergies), list of current medications, problem list
  7. 7. (Consultation) (Medico-legal purposes)
  8. 8. (Claims & Reimbursements) (Audit)
  9. 9. Electronic Medical Records Electronic documentation of health care provided to patients, as recorded by providers Ideally longitudinal (e.g., life-long) records Electronic Medical Records vs. Electronic Health Records EMRs snapshot 1 EHRs (longitudinal records)
  10. 10. Example of a Longitudinal Record
  11. 11. EHRs vs. EMRs 2 EMRs EHRs (Scanned Medical Records) (Fully-Electronic or Structured EHRs)
  12. 12. EHRs
  13. 13. Class Exercise #2 ?
  14. 14. (EHRs) (anytime, anywhere, everyone ) !!!!! () workflow Process improvement business process reengineering/redesign !!!!!
  15. 15. Are they just electronic documentation? Or do they have some other values? Diag- nosis History & PE Treat- ments ... EHR Systems
  16. 16. Functions that Should be Part of EHR Systems Computerized Medication Order Entry (IOM, 2003; Blumenthal et al, 2006) Computerized Laboratory Order Entry (IOM, 2003) Computerized Laboratory Results (IOM, 2003) Physician Notes (IOM, 2003) Patient Demographics (Blumenthal et al, 2006) Problem Lists (Blumenthal et al, 2006) Medication Lists (Blumenthal et al, 2006) Discharge Summaries (Blumenthal et al, 2006) Diagnostic Test Results (Blumenthal et al, 2006) Radiologic Reports (Blumenthal et al, 2006)
  17. 17. EHR Systems EHR system function EHR system Clinical Information System Hospital Information System
  18. 18. (Personal Health Records) Consumer Health Informatics
  19. 19. Consumer Health Informatics (CHI) The field devoted to informatics from a consumer view. (Hersh, 2009)
  20. 20. M/B/H Informatics As A Field (Hersh, 2009)
  21. 21. Examples of Areas within Consumer Health Informatics Image Source:
  22. 22. Image Source: Examples of Areas within Consumer Health Informatics: Health Literacy
  23. 23. Examples of Areas within Consumer Health Informatics: Health Literacy Image Source:,
  24. 24. Examples of Areas within Consumer Health Informatics: Social Media & Social Networking Sites Image Source:
  25. 25. Examples of Areas within Consumer Health Informatics: Consumer-oriented m-Health Image Source:
  26. 26. mHealth
  28. 28. Roles of ICT in Consumer Health Informatics Access to information Networking opportunities Education/Self-study Personalization Effective & efficient communications Empowerment User Experience
  29. 29. Issues in Consumer Health Informatics Health literacy & IT literacy Cultural diversity & sensitivity Usability, information presentation Impact of ICT on behavioral modifications Integration with providers systems Information exchange & interoperability Business model Privacy & security
  30. 30. (Personal Health Records)
  31. 31. Personal Health Records (PHRs) An electronic application through which individuals can access, manage and share their health information, and that of others for whom they are authorized, in a private, secure, and confidential environment. (Markle Foundation, 2003) A PHR includes health information managed by the individual... This can be contrasted with the clinicians record of patient encounterrelated information [a paperchart or EHR], which is managed by the clinician and/or health care institution. (Tang et al., 2006)
  32. 32. Types of PHRs Patient portal from a providers EHRs (tethered PHRs) Online PHRs Stand-alone Can be integrated with EHRs from multiple providers (unidirectional/bidirectional data sharing) Stand-alone PHRs PC-based applications USB Drive CD-ROM or other data storage devices Paper
  33. 33. PHRs and Other Systems (Tang et al., 2006)
  34. 34. Ideal PHRs Integrated Accessible Secure Comprehensive Accurate & current Patient able to manage sharing & update information Engaging & educational User-friendly, culturally & literacy appropriate The Hub and Spoke Model (Kaelber et al., 2008)
  35. 35. Use Cases of PHRs Data entry/update by patients Data retrieval by providers With patients consent Break-the-glass emergency access Data update from EHRs Privacy settings Personalized patient education Communications with providers
  36. 36. Data in PHRs (Tang et al., 2006)
  37. 37. Other IT for Consumer Health Traditional Web MedlinePlus Other sites Social Media The Usuals: MySpace, Facebook, Twitter Blogs, forums PatientsLikeMe Telemedicine & Telehealth Home monitoring/recording devices Tele-consultations, virtual visits
  38. 38. The Future Microsoft Health: Future Vision bb45-d6a553496168
  39. 39. Next: Meaningful Use of EHRs
  40. 40. References Blumenthal D, DesRoches C, Donelan K, Ferris T, Jha A, Kaushal R, Rao S, Rosenbaum S. Health information technology in the United States: the information base for progress [Internet]. Princeton (NJ): Robert Wood Johnson Foundation; 2006 [cited 2010 Oct 14]. 81 p. Available from: Hersh W. A stimulus to define informatics and health information technology. BMC Med Inform Decis Mak. 2009;9:24. Institute of Medicine, Board on Health Care Services, Committee on Data Standards for Patient Safety. Key Capabilities of an electronic health record system: letter report [Internet]. Washington, DC: National Academy of Sciences; 2003 [cited 2010 Oct 14]. 31 p. Available from: