Sunday, November 1, 2009

Do You PHR Yet?

Each spring, I travel with a group of Rotarians to Nicaragua to help build healthcare clinics in remote areas. Before the trip, I always make an elaborate spreadsheet containing the medical information of each member of our team- allergies, immunizations, chronic conditions, medications, etc. –in case something happens and any of us need medical attention. 

Although useful, the spreadsheet model obviously isn't the most efficient tool available for compiling and storing a medical record. Recently, I’ve been intrigued by personal health record (PHR) applications that are available online. The functional model of a PHR, defined by the HL7 organization, allows for the easy query of immunization records and access to medical information–subject to the proper authorization. The capability to access the health record of any member of the Nicaragua team from an Internet-capable device is certainly better than carrying around a spreadsheet file. 

On a personal level, a recent trip to my local clinic convinced me of the benefits of maintaining a PHR. It took a receptionist ten minutes to type in my demographic information and medical history–even though I had been seen at that location less than two years ago. It turns out the facility had deployed a new health record system and had been unable to migrate any historic data. A simple URL link to my PHR with the proper authorization could have eliminated this problem. 

These are two simple examples of how a PHR can increase efficiency; on a more pragmatic level, this technology has the potential to minimize the possibility of adverse drug interactions as well as prevent other common medical errors. 

PHR’s are available today from many providers. Of particular note, IT industry heavyweights Google and Microsoft are attempting to carve out a share of this market. HIS and EMR vendors are also trying to stake a claim in this space; however, many of these PHR systems are "tethered" to a facility or vendor application. 

For example, a hospital here in Dallas encourages its patients to use a PHR it provides. Unfortunately, the PHR is a vendor-based system that is, for all practical information transfer/access purposes, useless outside that institution. 

Other than the obvious benefit to be gained from having a PHR, why are these applications of interest to medical imaging IT professionals? I’m fairly certain that it won’t be too long before patients begin arriving with a URL link to their prior imaging studies, which are stored in their PHR. And yes, there will undoubtedly be interoperability issues with a PACS.