Appl Clin Inform 2016; 07(02): 355-367
DOI: 10.4338/ACI-2015-11-RA-0156
Research Article - H3IT Special Topic
Schattauer GmbH

Assessing commercially available personal health records for home health

Recommendations for design
Laura Kneale
1   University of Washington Biomedical and Health Informatics
,
Yong Choi
1   University of Washington Biomedical and Health Informatics
,
George Demiris
1   University of Washington Biomedical and Health Informatics
2   University of Washington School of Nursing
› Institutsangaben
The authors would like to thank the Home Health and Hospice Information Technology (H3IT) Conference for the opportunity to present this work. This study was supported in part by the National Library of Medicine Biomedical and Health Informatics Training Grant at the University of Washington Grant Nr. T15LM007442.
Weitere Informationen
Correspondence to:
Laura Kneale
Biomedical and Health Informatics
Department of Biomedical Informatics and Medical
Education
University of Washington
Box 358047
Seattle, WA 98195

Publikationsverlauf

received: 20. November 2015

accepted: 28. Februar 2016

Publikationsdatum:
16. Dezember 2017 (online)

 

Summary

Background

Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information.

Objectives

To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study.

Methods

Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality.

Results

Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data.

Conclusions

The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.


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Conflict of Interest

The authors have no conflicts of interest to report. Human Subject Protections

  • References

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  • 2 Olsen RM, Hellzen O, Skotnes LH, Enmarker I. Breakdown in informational continuity of care during hospitalization of older home-living patients: a case study. Int J Integr Care 2014; 14: e012 PubMed PMID: 24868195; PubMed Central PMCID: PMC4027933.
  • 3 Dykes PC, Samal L, Donahue M, Greenberg JO, Hurley AC, Hasan O, O’Malley TA, Venkatesh AK, Volk LA, Bates DW. A patient-centered longitudinal care plan: vision versus reality. J Am Med Inform Assoc. 2014; 21 (06) 1082-1090 doi: 10.1136/amiajnl-2013–002454. PubMed PMID: 24996874; PubMed Central PMCID: PMC4215040.
  • 4 Bowles KH, Pham J, O’Connor M, Horowitz D. Information deficits in home care: a barrier to evidencebased disease management. HHCMP 2010; 22 (04) 278-285.
  • 5 Connecting for Health, Markle Foundation. The personal health working group: final report. New York: NY; Markle Foundation[Internet]. 2003. [cited 2015 December 1]. 58 p. Available from: http://www.markle.org/publications/1429-personal-health-working-group-final-report.
  • 6 myPHR [Internet]. Chicago: IL; The American Health Information Management Association; c2015 [cited 2015 November 5]. Available from: http://www.myphr.com/.
  • 7 What is a personal health record? [Internet]. Washington: Department of Health and Human Services; 2013. [cited 2015 November 30]. Available from: https://www.healthit.gov/providers-professionals/faqs/what-personal-health-record.
  • 8 Turvey C, Klein D, Fix G, Hogan TP, Woods S, Simon SR, Charlton M, Vaughan-Sarrazin M, Zulman DM, Dindo L, Wakefield B, Graham G, Nazi K. Blue Button use by patients to access and share health record information using the Department of Veterans Affairs’ online patient portal. J Am Med Inform Assoc 2014; 21 (04) 657-663 doi: 10.1136/amiajnl-2014–002723. PubMed PMID: 24740865; PubMed Central PMCID: PMC4078285.
  • 9 Dey JG, Johnson M, Pajerowski W, Tanamor M, Ward A. Home Health Study Report. Baltimore: Centers for Medicare and Medicaid Services; 2011
  • 10 Choose a PHR [Internet]. Chicago: IL; the American Health Information Management Association c2015 [cited 2015 November 5]. Available from: http://myphr.com/resources/choose.aspx.
  • 11 Carrion ISenor, Fernandez-Aleman JL, Toval A. Are personal health records safe? A review of free webaccessible personal health record privacy policies. J Med Internet Res 2012; 14 (04) e114 doi: 10.2196/jmir.1904. PubMed PMID: 22917868; PubMed Central PMCID: PMC3510685.
  • 12 Pai HH, Lau F, Barnett J, Jones S. Meeting the health information needs of prostate cancer patients using personal health records. Curr Oncol 2013; 20 (06) e561-e569 doi: 10.3747/co.20.1584. PubMed PMID: 24311957; PubMed Central PMCID: PMC3851353.
  • 13 Millerick Y. Case study 6: an account of a patient’s journey following a diagnosis of left ventricular systolic dysfunction of ischaemic aetiology. In: Stewart S, Blue L. editors. Improving Outcomes in Chronic Heart Failure: A practical guide to specialist. 2nd ed.. London: BMJ Publishing Group; 2004: 226-32.
  • 14 Administration on Aging, Administration for Community Living. A Profile of Older Americans. 2012. Washington: U.S; Department of Human and Health Services. 2012: 14.
  • 15 Hines AL, Barrett ML, Jiang HJ, Steiner CA. Conditions with the largest number of adult hospital readmissions by payer. 2011. Rockville (MD): The Agency for Healthcare Research and Quality; 2014
  • 16 Medem iHealthRecord [Internet]. Mountain View: CA: Intuit; c2015 [cited 2015 July 15]; Available from: http://www.medemphr.mymedfusion.com.
  • 17 MyWellnessHub [Internet]. [cited 2015 July 15]. Available from: http://phr.emrystick.com.
  • 18 MiVIA: Connecting Patients and Clinicians Nationwide. [Internet]. Sonoma: CA: MiVIA; c2013 [cited 2015 July 15]. Available from: https://www.mivia.org.
  • 19 MyHealthFolders.com [Internet]. St. Louis: MO: BJC; c2015. [cited 2015 July 15]. Available from: https://www.myhealthfolders.com.
  • 20 MyChart [Internet]. Verona: WI: Epic Systems; c1999-2013 [cited 2015 July 15]. Available from: https://www.mychartlink.com/MyChart/.
  • 21 ZebraHealth [Internet]. Kirkland, WA: ZebraHealth Inc; [cited 2015 July 15]. Available from: https://www.zebrahealth.com.
  • 22 About My Health: Experience. Learn. Share [Internet]. Nottingham: UK: EDIO Healthcare; [cited 2015 July 15]. Available from: http://www.aboutmyhealth.org/.
  • 23 MedicAlert Foundation [Internet]. Turlock, CA: MedicAlert Foundation; [cited 2015 July 15]. Available from: http://www.medicalert.org/.
  • 24 dLife: It’s your diabetes life [Internet]. LifeMed Media. c2015 [cited 2015 July 15]. Available from: http://www.dlife.com.
  • 25 Zweena [Internet]. Hopewell: NJ; Zweena Health. [cited 2015 July 15]. Available from: http://zweena- health.com/.
  • 26 No More Clip Board [Internet]. Fort Wayne: IN; No More Clipboard. c2015 [cited 2015 November 5]. Available from: https://www.nomoreclipboard.com/.
  • 27 Healthspek [Internet]. Healthspek. c2015. [cited 2015 November 5]. Available from: http://www.health spek.com/.
  • 28 Health Companion [Internet]. San Diego: CA; Health Companion, Inc.; c. 2009-2015 [cited 2015 November 5]. Available from: https://www.healthcompanion.com/.
  • 29 HealthVault [Internet]. Redmond, WA: Microsoft; c2015. [cited 2015 November 5]. Available from: https://www.healthvault.com/us/en.
  • 30 RememberItNow [Internet]. Orinda: CA; RememberItNow LLC. [cited 2015 November 5]. Available from: http://www.rememberitnow.com/index.php.
  • 31 MyMedWall [Internet]. [cited 2015 November 5]. Available from: https://secure.mymedwall.com/phr/.
  • 32 Doclopedia [Internet]. Phoenix: AZ; Doclopedia Marketplace Development. [cited 2015 November 5]. Available from: https://www.doclopedia.com/.
  • 33 Wells S, Rozenblum R, Park A, Dunn M, Bates DW. Personal health records for patients with chronic disease: a major opportunity. Appl Clin Inform 2014; 05 (02) 416-429 doi: 10.4338/ACI-2014–01-RA-0002. PubMed PMID: 25024758; PubMed Central PMCID: PMC4081745.
  • 34 Studeny J, Coustasse A. Personal health records: is rapid adoption hindering interoperability?. Perspect Health Inf Manag. 2014 11. 1e PubMed PMID: 25214822; PubMed Central PMCID: PMC4142513.
  • 35 Smith A. Older Adults and technology use: adoption is increasing, but many seniors remain isolated from digital life. Washington: DC: Pew Research Center; 2014: 27.
  • 36 Gu Y, Day K. Propensity of people with long-term conditions to use personal health records. Stud Health Technol Inform 2013; 188 46-51 PubMed PMID: 23823287.
  • 37 Prey J, Ryan B, Quian M, Restaino S, Bakken S, Feiner SK, Schnall R, Hripcsak G, Han J, Vawdrey D. Interim Results of a Randomized Controlled Trial on Inpatient Engagement. AMIA Annu Symp Proc. 2015
  • 38 Sockolow PS, Bowles KH, Adelsberger MC, Chittams JL, Liao C. Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes. Appl Clin Inform 2014; 05 (02) 445-462 doi: 10.4338/ACI-2013–12-RA-0106. PubMed PMID: 25024760; PubMed Central PMCID: PMC4081747.

Correspondence to:
Laura Kneale
Biomedical and Health Informatics
Department of Biomedical Informatics and Medical
Education
University of Washington
Box 358047
Seattle, WA 98195

  • References

  • 1 Osborn R, Moulds D, Squires D, Doty MM, Anderson C. International survey of older adults finds shortcomings in access, coordination, and patient-centered care. Health Aff (Millwood) 2014; 33 (12) 2247-2255 doi: 10.1377/hlthaff.2014.0947. PubMed PMID: 25410260.
  • 2 Olsen RM, Hellzen O, Skotnes LH, Enmarker I. Breakdown in informational continuity of care during hospitalization of older home-living patients: a case study. Int J Integr Care 2014; 14: e012 PubMed PMID: 24868195; PubMed Central PMCID: PMC4027933.
  • 3 Dykes PC, Samal L, Donahue M, Greenberg JO, Hurley AC, Hasan O, O’Malley TA, Venkatesh AK, Volk LA, Bates DW. A patient-centered longitudinal care plan: vision versus reality. J Am Med Inform Assoc. 2014; 21 (06) 1082-1090 doi: 10.1136/amiajnl-2013–002454. PubMed PMID: 24996874; PubMed Central PMCID: PMC4215040.
  • 4 Bowles KH, Pham J, O’Connor M, Horowitz D. Information deficits in home care: a barrier to evidencebased disease management. HHCMP 2010; 22 (04) 278-285.
  • 5 Connecting for Health, Markle Foundation. The personal health working group: final report. New York: NY; Markle Foundation[Internet]. 2003. [cited 2015 December 1]. 58 p. Available from: http://www.markle.org/publications/1429-personal-health-working-group-final-report.
  • 6 myPHR [Internet]. Chicago: IL; The American Health Information Management Association; c2015 [cited 2015 November 5]. Available from: http://www.myphr.com/.
  • 7 What is a personal health record? [Internet]. Washington: Department of Health and Human Services; 2013. [cited 2015 November 30]. Available from: https://www.healthit.gov/providers-professionals/faqs/what-personal-health-record.
  • 8 Turvey C, Klein D, Fix G, Hogan TP, Woods S, Simon SR, Charlton M, Vaughan-Sarrazin M, Zulman DM, Dindo L, Wakefield B, Graham G, Nazi K. Blue Button use by patients to access and share health record information using the Department of Veterans Affairs’ online patient portal. J Am Med Inform Assoc 2014; 21 (04) 657-663 doi: 10.1136/amiajnl-2014–002723. PubMed PMID: 24740865; PubMed Central PMCID: PMC4078285.
  • 9 Dey JG, Johnson M, Pajerowski W, Tanamor M, Ward A. Home Health Study Report. Baltimore: Centers for Medicare and Medicaid Services; 2011
  • 10 Choose a PHR [Internet]. Chicago: IL; the American Health Information Management Association c2015 [cited 2015 November 5]. Available from: http://myphr.com/resources/choose.aspx.
  • 11 Carrion ISenor, Fernandez-Aleman JL, Toval A. Are personal health records safe? A review of free webaccessible personal health record privacy policies. J Med Internet Res 2012; 14 (04) e114 doi: 10.2196/jmir.1904. PubMed PMID: 22917868; PubMed Central PMCID: PMC3510685.
  • 12 Pai HH, Lau F, Barnett J, Jones S. Meeting the health information needs of prostate cancer patients using personal health records. Curr Oncol 2013; 20 (06) e561-e569 doi: 10.3747/co.20.1584. PubMed PMID: 24311957; PubMed Central PMCID: PMC3851353.
  • 13 Millerick Y. Case study 6: an account of a patient’s journey following a diagnosis of left ventricular systolic dysfunction of ischaemic aetiology. In: Stewart S, Blue L. editors. Improving Outcomes in Chronic Heart Failure: A practical guide to specialist. 2nd ed.. London: BMJ Publishing Group; 2004: 226-32.
  • 14 Administration on Aging, Administration for Community Living. A Profile of Older Americans. 2012. Washington: U.S; Department of Human and Health Services. 2012: 14.
  • 15 Hines AL, Barrett ML, Jiang HJ, Steiner CA. Conditions with the largest number of adult hospital readmissions by payer. 2011. Rockville (MD): The Agency for Healthcare Research and Quality; 2014
  • 16 Medem iHealthRecord [Internet]. Mountain View: CA: Intuit; c2015 [cited 2015 July 15]; Available from: http://www.medemphr.mymedfusion.com.
  • 17 MyWellnessHub [Internet]. [cited 2015 July 15]. Available from: http://phr.emrystick.com.
  • 18 MiVIA: Connecting Patients and Clinicians Nationwide. [Internet]. Sonoma: CA: MiVIA; c2013 [cited 2015 July 15]. Available from: https://www.mivia.org.
  • 19 MyHealthFolders.com [Internet]. St. Louis: MO: BJC; c2015. [cited 2015 July 15]. Available from: https://www.myhealthfolders.com.
  • 20 MyChart [Internet]. Verona: WI: Epic Systems; c1999-2013 [cited 2015 July 15]. Available from: https://www.mychartlink.com/MyChart/.
  • 21 ZebraHealth [Internet]. Kirkland, WA: ZebraHealth Inc; [cited 2015 July 15]. Available from: https://www.zebrahealth.com.
  • 22 About My Health: Experience. Learn. Share [Internet]. Nottingham: UK: EDIO Healthcare; [cited 2015 July 15]. Available from: http://www.aboutmyhealth.org/.
  • 23 MedicAlert Foundation [Internet]. Turlock, CA: MedicAlert Foundation; [cited 2015 July 15]. Available from: http://www.medicalert.org/.
  • 24 dLife: It’s your diabetes life [Internet]. LifeMed Media. c2015 [cited 2015 July 15]. Available from: http://www.dlife.com.
  • 25 Zweena [Internet]. Hopewell: NJ; Zweena Health. [cited 2015 July 15]. Available from: http://zweena- health.com/.
  • 26 No More Clip Board [Internet]. Fort Wayne: IN; No More Clipboard. c2015 [cited 2015 November 5]. Available from: https://www.nomoreclipboard.com/.
  • 27 Healthspek [Internet]. Healthspek. c2015. [cited 2015 November 5]. Available from: http://www.health spek.com/.
  • 28 Health Companion [Internet]. San Diego: CA; Health Companion, Inc.; c. 2009-2015 [cited 2015 November 5]. Available from: https://www.healthcompanion.com/.
  • 29 HealthVault [Internet]. Redmond, WA: Microsoft; c2015. [cited 2015 November 5]. Available from: https://www.healthvault.com/us/en.
  • 30 RememberItNow [Internet]. Orinda: CA; RememberItNow LLC. [cited 2015 November 5]. Available from: http://www.rememberitnow.com/index.php.
  • 31 MyMedWall [Internet]. [cited 2015 November 5]. Available from: https://secure.mymedwall.com/phr/.
  • 32 Doclopedia [Internet]. Phoenix: AZ; Doclopedia Marketplace Development. [cited 2015 November 5]. Available from: https://www.doclopedia.com/.
  • 33 Wells S, Rozenblum R, Park A, Dunn M, Bates DW. Personal health records for patients with chronic disease: a major opportunity. Appl Clin Inform 2014; 05 (02) 416-429 doi: 10.4338/ACI-2014–01-RA-0002. PubMed PMID: 25024758; PubMed Central PMCID: PMC4081745.
  • 34 Studeny J, Coustasse A. Personal health records: is rapid adoption hindering interoperability?. Perspect Health Inf Manag. 2014 11. 1e PubMed PMID: 25214822; PubMed Central PMCID: PMC4142513.
  • 35 Smith A. Older Adults and technology use: adoption is increasing, but many seniors remain isolated from digital life. Washington: DC: Pew Research Center; 2014: 27.
  • 36 Gu Y, Day K. Propensity of people with long-term conditions to use personal health records. Stud Health Technol Inform 2013; 188 46-51 PubMed PMID: 23823287.
  • 37 Prey J, Ryan B, Quian M, Restaino S, Bakken S, Feiner SK, Schnall R, Hripcsak G, Han J, Vawdrey D. Interim Results of a Randomized Controlled Trial on Inpatient Engagement. AMIA Annu Symp Proc. 2015
  • 38 Sockolow PS, Bowles KH, Adelsberger MC, Chittams JL, Liao C. Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes. Appl Clin Inform 2014; 05 (02) 445-462 doi: 10.4338/ACI-2013–12-RA-0106. PubMed PMID: 25024760; PubMed Central PMCID: PMC4081747.