Provider organizations have to address several critical issues when launching personal health records (PHR) projects, one consultant says. Among those issues, he says, is whether to enable patients to access a complete electronic health record (EHR) and export it to a PHR—a step that John Moore, managing partner of Chilmark Research, Cambridge, Mass., advocates.

Hospitals and clinics also must decide what data elements are most essential to a PHR. Although many agree that medication lists and allergies must be in a PHR, providers are pondering whether to include all lab tests as well as diagnostic images, Moore notes.

Providers also must determine whether to enable patients to add their own notes to data imported from an EHR to a PHR, such as to question a doctor's findings, the consultant says. Plus, they must determine whether those patient notes will then flow into the EHR.

A strong advocate of two-way links between EHRs and PHRs, Moore also says practice management systems should be added to the mix to help enable patients to use a PHR to, for example, schedule an appointment.

PHRs need to be portable because so many patients move from city to city and want to maintain access to historical records, adds Steven Fox, VP of provider network management at Blue Cross Blue Shield of Massachusetts, Boston. "We have to trust the consumer like banks do," he argues.

The Blues plan is enabling thousands of its members to create PHRs using technology from Google Health. The insurer automatically populates the PHRs with claims data. In addition, patients who are treated by physicians who practice at Beth Israel Deaconess Medical Center in Boston have their PHRs populated with data from their EHRs, Fox notes.

The Blues plan is now studying how well data from claims, EHRs, reference labs and pharmacies is synchronized within the PHRs so consumers can actually use the data.

Moore and Fox made their comments Sept. 18 at Health Data Management's Health I.T. Stimulus Summit in Boston.

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