Time to Kill the PHR Term

Language can be magic carpet that takes thoughts to new and interested places; it can also be a trap. This blog has been about electronic medical records—EMRs—generated by healthcare providers. A corollary to that has been a personal version of EMRs from multiple providers that make up a personal health record—PHR for an individual. There is a trap in dealing with the personal version as a collection of information from other records. The PHR is reduced to a record or data rather than becoming a tool that supports the individual’s efforts to improve and maintain good health.

Microsoft Health Vault, Google Health, and similar programs use the Internet and linked tools including iPhones and “smart” medical devices to create the needed tool or “platform” for more than just records. John Moore of Chilmark Research argues that it is time to move from PH-Record to PH-Platform and I agree

Quoting from John’s post:

… where we really get concerned with the PHR term is that in the meaningful use recommendations that were accepted in July.   Under meaningful use guidelines, those obtaining Stimulus (ARRA) funding for adoption of a certified EHR must provide a PHR to their patients by 2013.  Trouble here is how will HHS define what that PHR is?  Last year, HHS [had] the PHR term defined (see below).  This term, we have been told, is what will be used within the context of meaningful use rule making.  If this is indeed true, adoption of PHRs will continue to be lackluster.

PHR, Personal Health Record: “An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.”

To move beyond the limitations of this definition (and the baggage that goes with it) Chilmark proposes a new term, Personal Health Platforms (PHPs) with the hope that others will pick up the banner moving us beyond where we are today and hopefully get HHS to look beyond the narrow confines of the PHR definition that they have before them.

What is a Personal Health Platform?

Our proposed definition is as follows:

A Personal Health Platform (PHP) is an Internet-based platform that securely stores and manages a citizen’s personal health data, data that may be derived from multiple sources including among others clinical systems, payer systems, self-enter data, and biometric.  The PHP also provides the framework and capabilities to support applications, services and/or tools that a citizen may invoke to leverage their personal health data enabling the citizen to make better, more well-informed decisions regarding their health or the health of a loved one.

The second sentence of that definition is the key differentiator. A PHP does more than simply store the data, it makes that data actionable.

In a nut shell, we keep the records and the communication links and interfaces that create the personal records and we add capabilities that support additional information and make all of the information actionable. That is a result that is worth the effort.

See also: Including patients in EMRs and
What if? What if we expand the definition of EMR?


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