But Boyer isn't putting all of her "interoperability" stock into PHRs. She also plans to move on both the RHIO and PHR fronts. The RHIO concept will take longer than people realize, she says, explaining that there are still security and consent concerns that need to be resolved. "If we are going to interconnect everyone, I see an awful lot of interfaces, so I'm not sure that will happen real fast," Boyer says. In the meantime, organizations can use PHRs to improve the situation, she says.
Hood agrees that organizations should provide patients better access to their health information sooner than later, but Group Health has taken a different approach by using an online patient portal to provide patients access to their data. Group Health's portal has more than 174,000 users; patients can view items such as lab result, medications, allergies, and immunizations and can add information about current health issues and family history through a health risk assessment questionnaire.
"Our philosophy has always been that the medical record is a shared document between the patient and caregiver and it should be the same content provided to both of them with different context," Hood says. For example, the record that patients view incorporates definitions.
Because some patients receive care from other providers, Hood says that a PHR could play an important role in the continuity of patient information. That was one of the deciding factors for New York-Presbyterian. "We felt it was more compelling—particularly in our marketplace—because patients don't necessarily always come to us," Boyer says. "They would be able to transport that record."
Hood is still concerned that until a large number of providers begins interfacing with PHR products, their use will be solely for the patient, by the patient; and, unfortunately, a relatively small number of patients currently maintains and actively uses PHRs.
Online banking had a slow adoption rate initially, as well, says Sidna Tulledge-Scheitel, MD, medical director for Mayo Clinic Global Products and Services. "We believe that this is similar to that and will catch on with time."
Mayo Clinic launched its Mayo Clinic Health Manager, a free online application that sits on top of Microsoft HealthVault and provides people a place to store health information and receive individualized health reminders and guidance.
Mayo's application generates customized recommendations based on the personal health information stored in the HealthVault platform that people can use to better manage their health and the health of their families.
From a physician perspective, Tulledge-Scheitel likes knowing that her patients with chronic conditions will receive additional support throughout the year. "That is the first step in trying to prepare for a pay-for-value environment," she says. Mayo Clinic Health Manager also empowers the person and family unit to get more involved in their health. "Putting patients at the center is the right approach," says Tulledge-Scheitel.