Healthy Living The Potential Of Personal Wellness Records (Phrs) - Business Office Three Of 3

In my previous ii posts, I summarized a deep conversation amongst a grouping of knowledgeable people close PHRs. I together with thus offered an innovative, depression cost, uncomplicated solution to bargain amongst the concerns others raised. Following is a continuation of the discussion.
One commenter wrote:

…In reading close PHRs (or EMRs) I oftentimes terminate upwards wondering if the underlying premise is faulty. Many existing electronic records seem to a greater extent than similar uncomplicated the wellness tape equivalent of "brochureware;" putting the newspaper tape upwards inward a pretty online version, perpetuating rather than re-imagining the concept. [As I run into it,] in that place are 3 key pieces to a PHR/EMR: the rootage data, how the information is authored/generated/input, together with which information gets presented when to whom. (I suppose the analytics that human activity on the information are a 4th crucial piece). The tertiary slice is genuinely a CRM [(customer human relationship management] question, together with the solution does non request to locomote a monolithic construction that tries to accept all answers to all questions presented at once. It may locomote a package of solutions, looking together with acting completely unlike for unlike users or fifty-fifty for the same user at unlike times. [We need] PHR solutions that intermission the existing paradigm.

I replied:

I'd add together a 5th key piece, i.e., how to exchange/share the information securely together with efficiently betwixt disparate applications without busting silos. Also, when it comes to presenting the data, inward add-on to tailoring information sets to user needs, in that place should locomote a focus on how the same information instruct presented differently to unlike users (e.g., mapping terminologies to user roles, such every bit providing explanations for technical price to patients). And I similar the analytics to locomote tied to evidence based guidelines the furnish conclusion back upwards together with instruction.

This requires a epitome busting PHR solution inward which bundles of solutions are made available. So, what nosotros request is a flexible, affordable, modular solution that enables many unlike applications to piece of employment together (interoperate), which is the really variety of organization I've been advocating using a pub/sub node-to-node architecture for exchanging encrypted information files, together with using template-based PHRs to swallow those information files, every bit good every bit to connect to most whatsoever third-party software programs together with information stores.

Another commenter together with thus wrote:

We request to proceed inward heed that, non until the focus of healthcare together with wellness is changed i from beingness reactive & curative [to i focusing on] preventive healthcare strategies [for both] physical & mental health.

I agreed, stating that it is crucial to integrate sick-care amongst prevention/well-care from a heed (psychological) together with trunk (biomedical) perspective.
I together with thus responded to an before comment close PHRs inward world clouds, PHR functionaliy, together with consumers' willingness to locomote inward information into PHRs:

Using world clouds using a centralized database for PHRs poses a safety run a peril that has non been adequately addressed, although private clouds—e.g., behind a provider's firewall—appear to a greater extent than secure. And I nonetheless fence that local storage of encrypted information files makes the most feel inward price of security, accessibility together with portability.

I likewise intend that the best mode to furnish multifaceted ever-evolving PHR functionality is through PHR add-ons, i.e., applications that tin locomote used inward conjunction amongst whatsoever PHR to create total its function/feature gaps.

With regard to the willingness of consumers to locomote inward information into a PHR, I advise approximately other element has to exercise amongst the usefulness of the information beingness entered. If people believe it volition assist them (and their providers) bargain to a greater extent than effectively amongst a wellness run a peril or problem, together with for less cost, the to a greater extent than probable the mortal volition pass the fourth dimension doing it. If it's merely a glorified medical tape that mirrors what's inward EMRs/EHRs, together with thus in that place less incentive to exercise so.

Another commenter wrote close problems amongst PHRs from a practitioner's indicate of view, to which I replied:

The incentive to break "proprietary information together with methods of the private practitioner and/or the establishment providing care," imo, depends on who gets the information together with how it is used. Let's say, for example, that a principal purpose of HIEs (Health Information Exchange) is to locomote warehouses/repositories that accumulate together with aggregate extensive information sets of biomedical, psychological together with environmental patient PHI inward de-identified form, along amongst the associated plans of aid (both sick-care together with well-care/prevention information http://wellness.wikispaces.com/Tactic+-+Well-Care+Sick-Care+Integration ).

Such an HIE would include affliction registries, biosurveillance together with handling outcomes databases. Analyzing these information would furnish key information helping to protect world wellness together with enabling comprehensive handling cost-effectiveness inquiry that focuses on identifying together with refining the evidence-based guidelines (protocols, pathways, treatments/procedures) most probable to locomote of greatest value to each patient/consumer dealing amongst a detail status or run a peril factor. In this case, both patient together with provider information are necessary, and, every bit such, the providers' identification could likewise locomote hidden (i.e., past times de-identifying the treatment-related data). An HIE should not, on the other hand, locomote a centralized database of identifiable PHI since that would locomote silo-busting, which has many negatives every bit I've previously discussed. In whatsoever case, the variety of incentive you lot suggested (payment token) could assist facilitate it.

And I responded to comments close the lack of usefulness of PHRs this way"

If a PHR really helps a mortal handgrip their physical, mental, emotional together with spiritual lives inward a mode that improves their wellness together with character of life, together with thus it's useful. That's because in that place would locomote a meaning departure inward the information the PHR contains together with the feedback & guidance the PHR provides. For example, inward add-on to the typical biomedical information together with observations of daily living (ODL), the PHR would include substantial PHI regarding a person's emotional state, beliefs systems, interpersonal relationships, behavioral tendencies, etc., which are non component subdivision of whatsoever EMR/EHR, together with approximately of which the mortal may non desire to portion amongst a doc (and which the doc may non request or desire to know). So, it has to exercise amongst one's vision of what a PHR should/could be.

Bottom line: We've got to intend inward a whole unlike mode close what PHRs should be!

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