Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care
Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care
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DOI：
10.1186/1472-6947-8-45
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发表时间：
2008-10-06
影响因子：
3.5
通讯作者：
Tang, Paul
中科院分区：
文献类型：
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作者：
Detmer, Don;Bloomrosen, Meryl;Tang, Paul
背景资料：综合个人健康记录（PHR）提供了巨大的潜力，刺激医疗保健服务和病人自我保健的转型变化。2006年，由凯泽永久研究所、美国医学信息学协会和医疗保健研究和质量机构主办的邀请圆桌会议举行，以确定PHR的变革潜力，以及实现这种潜力的障碍和行动框架，使其更接近医疗保健主流。讨论：虽然有一系列占主导地位的PHR模型（独立的、拴系的、集成的），但作者指出，只有集成模型才具有真正的变革潜力，可以加强消费者管理自己医疗保健的能力。综合的PHR提高了患者提供的健康信息的质量、完整性、深度和可访问性;使患者和提供者之间能够轻松沟通;为患者提供健康知识;确保医疗记录和其他个人健康信息的便携性;并纳入内容的自动填充。许多因素阻碍了综合PHR的广泛采用：卫生保健系统/文化中的障碍;消费者信心和信任问题;缺乏互操作性的技术标准;缺乏HIT基础设施;数字鸿沟;不确定的价值实现/ROI;以及不确定的市场需求。最近的努力导致在综合公共卫生报告标准方面取得进展，政府机构和私营公司正在向消费者提供不同的模式，但仍有大量障碍有待解决。立即采取措施，以促进综合PHRs应包括分享现有的知识和扩大有关他们的知识，建立在现有的努力，并继续在公共和私营部门的利益相关者之间的对话。摘要：综合PHRs促进积极的，持续的病人合作，在医疗服务和决策。然而，除了一些例外，综合PHR模型仍然是以消费者为中心的医疗保健的理论框架。作者提出了需要回答的问题，以便该领域能够向前迈进，实现综合PHR的潜力。综合的公共卫生报告如何从概念变为实际应用？一个协调机构能否加快这一进程？现有的倡议和政策杠杆如何能够成为推动综合的医生和保健建议的催化剂？
Background: Integrated personal health records (PHRs) offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this potential and a framework for action to move them closer to the health care mainstream. This paper highlights and builds on the insights shared during the roundtable.Discussion: While there is a spectrum of dominant PHR models, (standalone, tethered, integrated), the authors state that only the integrated model has true transformative potential to strengthen consumers' ability to manage their own health care. Integrated PHRs improve the quality, completeness, depth, and accessibility of health information provided by patients; enable facile communication between patients and providers; provide access to health knowledge for patients; ensure portability of medical records and other personal health information; and incorporate auto-population of content. Numerous factors impede widespread adoption of integrated PHRs: obstacles in the health care system/culture; issues of consumer confidence and trust; lack of technical standards for interoperability; lack of HIT infrastructure; the digital divide; uncertain value realization/ROI; and uncertain market demand. Recent efforts have led to progress on standards for integrated PHRs, and government agencies and private companies are offering different models to consumers, but substantial obstacles remain to be addressed. Immediate steps to advance integrated PHRs should include sharing existing knowledge and expanding knowledge about them, building on existing efforts, and continuing dialogue among public and private sector stakeholders.Summary: Integrated PHRs promote active, ongoing patient collaboration in care delivery and decision making. With some exceptions, however, the integrated PHR model is still a theoretical framework for consumer-centric health care. The authors pose questions that need to be answered so that the field can move forward to realize the potential of integrated PHRs. How can integrated PHRs be moved from concept to practical application? Would a coordinating body expedite this progress? How can existing initiatives and policy levers serve as catalysts to advance integrated PHRs?