When a PHR system is tied to a practice's EHR via a website it becomes a powerful tool, capable of drawing in patients to schedule appointments, view test results, renew prescriptions, and send messages to their physicians, says Johnathan Samples, executive vice president of research and development for Greenway Medical, which focuses its product line on the ambulatory care market.
"We're seeing the personal health record grow from just a single standalone repository of information to a system that is interoperable with other devices and mobile applications," Samples says. "The inputs are coming from a multitude of entities, not just the electronic health record."
Indeed, health systems that have implemented PHRs, such as Kaiser Permanente and the Cleveland Clinic, are now trying to tie together home medical devices, appointment scheduling applications, test results delivery, patient-physician e-mail, and other features. The result, they hope, will be a PHR that supports a coordinated, information-rich virtual medical home for each patient.
"A lot of the patient-centered care models and accountable care models center around getting the patient engaged and communicating with the patient," Samples says. "The personal health record is a perfect way to do that."
Although not a primary driver of PHR adoption at present, meaningful use will make more inroads on the 90 percent of patients yet to embrace the technology. To qualify for meaningful use payments, eligible providers must provide at least half of their patients with electronic copies of their health information (including diagnostic test results and problem lists) upon request, as well as clinical summaries for each office visit.
In Stage 2, providers can expect more fuel for the growth of the PHR market. New criteria include secure patient-physician messaging, and enabling patients to view, download, and transmit their health information online.
Also setting the tone is the Federal Health IT Strategic Plan: 2011-2015, in which the government asserts a goal of empowering individuals with information about their health in an electronic format.
Ease of use
PHR usage among patients doesn't just happen; it must be promoted. And there's no better promotion than having a powerful, useable, and well-connected system ready for patients to use, says Pamela Larson, director of consumer health at Kaiser Permanente Internet Services Group.
By June 2012, some 3.9 million of Kaiser's 9 million members were registered for My Health Manager, a home-grown PHR tied into the health system's patient portal. While not every registrant is a frequent user, usage rates in the first half of 2012 are encouraging:
• 2.5 million lab results are viewed by patients online monthly;
• 1 million e-mails are sent by patients between patients and physicians monthly;
• 827,000 prescriptions are refilled online by patients monthly; and
• 230,000 appointments are scheduled by patients monthly.