Rise of Personal Health Records Stresses Need for Access to Complete Patient Information

In New York State, a patient portal is being rolled out that gives patients access to their health records through the state’s nine regional health information organizations (RHIOs), which are entities meant to foster health information exchange.

This summer also marked the unveiling of HealthKit, the Apple platform intended to allow health apps to feed their information into one place for the user to view easily, including information ranging from physician records from participating centers to fitness information gathered by users through their smartphones.

Taken all together, all these PHRs, EHRs, portals, apps, and platforms can seem to be a bit of a blur. But everything is trending in that direction, said Lydia Washington, senior director of health information management practice excellence with the American Health Information Management Association (AHIMA). The PHR concept rose in prominence when records began to be kept electronically, and the concept ramped up much more in 2009 with the passage of the Affordable Care Act and its meaningful use incentives, she said.

AHIMA, a group with 71,000 health information professionals working to promote the adoption of electronic health records, includes a consumer support arm that promotes the idea of greater patient access to their records. “When [patients] have access to their own health information, they sometimes find errors in that information and have the ability to correct it,” Washington said. “That contributes to the integrity of their health information.”

AHIMA works with physicians to encourage them to promote the PHR concept to patients, mainly through state associations that have closer contact with individual practitioners, Washington said.

In New York, the state portal is a step in the right direction, but the EHRs of participating medical centers aren’t standardized, said David Jakubowicz, MD, director of otolaryngology at Medalliance Medical Health Services in the Bronx, N.Y., who helped create a patient portal at his previous institution, Bronx Lebanon Hospital Center. “One of the problems with all these EHRs is that there is no format that these EHRs are supposed to be…. There’s an HL7 interface, but there isn’t the portability that a patient may want,” he said, referring to Health Level 7 International, a set of standards for electronic health information.

Certain EHRs can communicate via HL7, but not everything can be captured, he said. “If a physician makes commentary … and it’s not in the standard profile, it can’t be pulled,” he said. “It’s the narrative portions that have difficulty being pulled into these standards.”