A PHR can also erase the potential delays and missed opportunities when patients and physicians cannot meet face to face for important follow-up conversations. For instance, Harris credits the PHR, patient portal, and Web-accessible EHR for helping him quickly follow up with a patient after a concerning health issue surfaced in an office visit. By the time the patient's test results returned from the lab, the patient was off to Germany and Harris was on his way to San Diego. Harris was able to log in to the patient's record in the EHR from San Diego, assess the concerning test results, and then contact the patient in Germany for timely follow-up. That beats playing transcontinental phone tag, Harris says.
A more commonplace use of the PHR and its messaging capabilities involves stroke patients, Harris says. After discharge from the hospital, each stroke patient is signed up in MyChart so that the PHR can send patients functional status questionnaires to complete and return. "Formerly, the patients had to come into the office, but now we have the ability to get that information at the intervals we desire, and the patients don't have to leave their homes," Harris says.
Harris says the PHR has already reduced incoming phone call volume at many Cleveland Clinic medical practice offices.
"[MyChart] actually makes the office more efficient because the telephone has less demand and people who are calling in about an acute illness are getting through faster because their calls do not get backed up behind people asking for prescription renewals," he says.
But while PHRs and practice websites lead to smoother internal work flow, for instance, for patients the real benefit is clinical, Harris says. For example, scheduling is a Web-portal tool many patients wish to use. "The health information technology industry has always defined scheduling as an administrative tool, but at the Cleveland Clinic we think of it as a clinical tool, important to giving the physicians and patients a common understanding of what comes next," Harris says.
Types of PHRs
Personal Health Records (PHRs) are offered through employers, health insurers, health providers, and independent vendors. To get an idea of what's on the market and how many vendors there are, visit PHRsToday (http://www.phrstoday.com/ ), which includes reviews and other resources.
Here's an overview of some of the key types of PHRs available:
Tethered PHR. These PHRs are integrated or connected with the information system of the provider organization, health plan, or employer. They allow users to view portions of their clinical record or an abstract of their health record or claims data. Some systems allow patients to add information about their health status, workouts, etc.
EHR-, website-powered PHRs. These systems give users access to portions of their clinical record through their provider's website. Functions can include secure messaging to physicians, appointment scheduling, prescription refills, and patient-generated requests for documents, such as immunization records.
Untethered (also called "standalone") PHRs. With no direct connection to the provider's or health organization's EHR, the user must type in, scan, or download the health information he wishes to track. Patients can move the system and its information with them if they change physicians, insurance companies, or employers. The information is not necessarily available to the patient's provider.