Improving personal health records for patient-centered care.
OBJECTIVE
To assess the patient-centeredness of personal health records (PHR) and offer recommendations for best practice guidelines.


METHODS
Semi-structured interviews were conducted in seven large early PHR adopter organizations in 2007. Organizations were purposively selected to represent a variety of US settings, including medium and large hospitals, ambulatory care facilities, insurers and health plans, government departments, and commercial sectors.


METHODS
Patient-centeredness was assessed against a framework of care that includes: (1) respect for patient values, preferences, and expressed needs; (2) information and education; (3) access to care; (4) emotional support to relieve fear and anxiety; (5) involvement of family and friends; (6) continuity and secure transition between healthcare providers; (7) physical comfort; (8) coordination of care. Within this framework we used evidence for patient preferences (where it exists) to compare existing PHR policies, and propose a best practice model.


RESULTS
Most organizations enable many patient-centered functions such as data access for proxies and minors. No organization allows patient views of clinical progress notes, and turnaround times for PHR reporting of normal laboratory results can be up to 7 days.


CONCLUSIONS
Findings suggest patient-centeredness for personal health records can be improved, and recommendations are made for best practice guidelines.
Reti
Shane R
SR
Division of Clinical Informatics, Department of Medicine, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, Massachusetts 02446, USA. sreti@bidmc.harvard.edu
Feldman
Henry J
HJ
Ross
Stephen E
SE
Safran
Charles
C
D019985:Benchmarking; D003266:Continuity of Patient Care; D019538:Health Care Surveys; D055991:Health Records, Personal; D006801:Humans; D057240:Patient Preference; D018802:Patient-Centered Care / Q000458:organization & administration*; D014481:United States