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The Promise Of Electronic Health Records
AARP International - March 1, 2007

A unique opportunity exists to improve the quality of health care received by millions of Americans. Our current fragmented, paper-based, provider-focused health care delivery sector results in almost 100,000 preventable deaths, huge gaps in quality, millions of unnecessary hospitalizations, and hundreds of billions of dollars in avoidable costs each year.

The increasing availability of electronic health information and the checks and balances that this affords will certainly support clinicians in providing better care. Even more powerful, however, is the effect that individuals can have on their own health and care if they, too, have access to electronic information about themselves, their environment, and medical knowledge.

Personal Health Records (PHRs) are the tools that patients and consumers can use to become more active in their health and care, and assure that their care is coordinated across multiple physicians and settings. A survey conducted by the Markle Foundation indicated that 60 percent of respondents would use a secure online PHR service that would allow them to check and refill prescriptions, obtain test results, communicate with the doctors via email, and check for mistakes in their medical record1.

This type of independent PHR, which is controlled by the patient or their designee and includes entries by the patient and information drawn from other health care sources such as doctors, hospitals, pharmacies, or health insurance claims information, is one of at least three types now in use today. A second model is an isolated PHR where patients add their own information but which cannot exchange information with other sources, although patients can print or share this information online with whomever they feel is appropriate. The third model is a patient portal to the information available in a delivery system's electronic health record. This variant may provide access to personal health data and information as well as allow for direct communication with one's physicians and other clinicians.

Before any of these models can become widely available to all Americans, however, a number of critical issues need to be addressed to assure that these PHRs are secure, easy to use, can "talk" to other systems of care, and are accurate, affordable, and appropriate for all types of patients.

As Chair of the American Health Information Community (AHIC), a Federal Advisory committee that recommends actions related to supporting the Federal Government's HIT agenda, Health and Human Services Secretary Michael O. Leavitt is keenly interested in addressing these issues. To that end, the Consumer Empowerment workgroup was chartered to research, discuss and inform the AHIC on actions that may be taken. The workgroup is currently focusing on the following areas:

• Physician adoption of PHRs. Patients will find the PHR much more useful if their physicians have access to it as well.

• PHR standardization, certification, and uniform privacy protection to assure that the product used is reliable and secure.

• Clear communication regarding health information, treatment options, etc.

• Health literacy.

• Programs aimed at addressing incentives and interoperability of health information between PHRs and other health information systems and products.

Through these efforts, and others in the federal government and in the private sector, personal health information that can be shared among multiple electronic systems will become more widely available, and consumers will become more engaged in their own health and care. This sharing of health information will become the foundation for a different and better approach to health care. Our fragmented, costly, error-prone sector will be transformed into a high quality, reliable, efficient health care system that truly focuses on the consumer and patient. Care and guidance will be easily available wherever and whenever it is needed: school, home, or work. Access to one's personal information and to trustworthy information resources will guide treatment anytime or anyplace, whether at home or while traveling around the world. More specific patient-based information will guide more individualized treatments. And preventive services will be prompted to consumers in a timely fashion to maintain one's health.

We are on the threshold of a transformation: the steps currently being taken to develop, support, and offer consumer access to a wide array of health information will take us into a future where health and care is safe, effective, efficient, affordable, timely, and patient-focused-and available to all.




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