Compare and
contrast an EMR, EHR and PHR.
Characterize the similarities/differences of data between these systems.
Your response should examine the opportunities and issues of data interacting
between these systems as well as interactions between other system components /
applications.
Several years ago Google ventured upon starting a repository
for electronic personal health records. At
that time I stumbled upon this, and though I never signed up for it, I was
intrigued by this concept. This was a
way to keep all of your health information in one place that could be accessed
by yourself or anyone that you gave permission to access. Fast forward several years, and Google is
dumping this project. I bring this up
because I started a discussion on Linkedin.com about Google Health and called
the records stored there electronic medical records. Needless to say, someone on the discussion
corrected me and said that they were personal health records. This was the first time that I came to the
understanding that there is a difference between personal health records (PHR),
electronic health records (EHR) and electronic medical records (EMR).
The similarity between all three of these is that they all
hold information on an individual’s health, treatment and/or recovery. However, there could be quite a difference in
the data in these records.
PHRs are usually accessible via portals over the Internet
and are used by the patient to record their own health information. The patient uses some type of security to
access the information. They can then
give access to this information to whoever needs it. Since the patient is the one maintaining it,
this could lead to inaccurate data or missing data. This could be by human error, or if the
patient does not keep the record up-to-date.
As for the information contained in these records, Huba & Zhang
(2012) stated that some information found in these types of records could
include “lab test results, medication records, lists of past and future
appointments…and the outcomes of those appointments” (Huba & Zhang,
2012). The article also states that
certain demographics like age, name, etc (Huba & Zhang, 2012). The individual, not a health care
professional, manually adds these to the record.
Similarity EMRs would contain the same information as the
PHRs. They would include the same
demographics, the same lab results and the same medication records. However, these records would be more
comprehensive then PHRs. This is because
they are created by clinical professionals and would be less prone to error and
would include details from each and every patient encounter. They would also include progress notes, and
other nuances that a patient would not be able to include, due to their layman
status.
Further still, in terms of elevated comprehension, would be
the EHR, which would include information from certain heath care events, such
as surgeries or emergency care incidents.
These records would include information from various sections of a
healthcare organization or even over a larger geographic area. They would also include discharge notes,
pathology reports and other pieces of information that would not be generated
though a primary care visit.
One would think that interoperability of these systems would
be advantageous. However there are some
hurdles that need to be overcome before such a noble task is brought to
fruition. First the adoption of PHRs has
various barriers that could affect data reliability. Through a qualitative research project by
Matthew Witry et al (2010), it was found that “the likelihood that an
individual would consider PHRs as a method to manage personal health
information appears low’ due to “computer and health literacy affecting PHR
usability, especially in older adults” and concerns “with the privacy of their
personal health data (Witry, M, et al, 2010).
Because of the low usage of PHRs there are many accuracy concerns, and
less accurate data could present a problem with interoperability. If these barriers can be overcome the
benefits and opportunities for interoperability would be immense. This is especially true for “truckers,
snowbirds (retirees who travel south for the winter months), or anyone else who
spends a significant amount of time away from home” (Witry, M, et al, 2010).
In conclusion, PHRs, EMRs and EHRs are similar in some
aspects as they hold some identical information, while EMRs and EHRs can be
more comprehensive and accurate. Also,
the integration of these can pose a problem due to accuracy issues and slow adoption
of the general public of PHRs. Once
these barriers are breached, and adoption speeds up there are many
opportunities to be had.
References
Huba, N & Zhang, Y.
(2012 May 30). Designing
Patient-Centered Personal Health Records (PHRs): Health Care Professionals'
Perspective on Patient-Generated Data. Journal of Medical Systems, 36(6), pp.
3893 – 3905. DOI:
10.1007/s10916-012-9861-z
Witry, M., et al.
(2010 Jan 01). Family physician
perceptions of personal health records. Perspectives in Health Information
Management, 7, pg. 1d. PMID: 20697465
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