Why PHR when EHR is the record of future

Abstract

DOI: http://dx.doi.org/10.4038/sljbmi.v2i2.2246 Intr oduction: The 20th century has revolutionized the medical records system from outpatient cards to comprehensive unit records due to its important role played in effective healthcare delivery. The unit record system served almost the later half of the 20 th century and with the advent of information technology, the electronic health record gained global importance. The theme of this paper is “Why PHR required in 21st Century? When EHR is the record of the future? Materials and Methods : Examination of medical record system practiced in the last century will enlighten as to what type of medical records required for the 21 st century and beyond so that each and every individual of this globe will get swift, safe and good quality care with affordable cost. Results: Physicians need comprehensive information for providing effective care and depend on patient record. Patient care information is scattered, disintegrated due to patient gets treatment at different health organizations, And even within one institution, the specialty information is not integrated. Patient also at times, treats himself, self medication, and also uses other services such as herbal, Unani, homeopathy and Ayurveda. All these information is not available to physician. Discussions: In spit of the fact, the EHR is proved to be a great potential and the “record” of future, also has some implementation difficulties and is not helping in exchange of information. This is also a hurdle and being tackled by applying various international standards like HL7, SNOMED-CT, LOINC, ICD, DIOCOM, NCPDP etc., to be fully interoperable. The Definition of PHR: The “PHR is a Health Passbook containing the identification data of a person, is a lifelong electronic, universally available document, initiated at the time of birth, containing, mother’s delivery information including congenital anomaly, immunizations given. This health passbook will have briefly entire information such as episodic, hospitalization, self medications and other habits including significant events, advance directives of living wills, organ donor authorization, usually not available to care providers. The PHR is maintained by parents/guardian till the child become responsible, followed by child development information including, immunizations, growth charts, significant events and health status. The PHR which comes from healthcare providers and individuals is a resource of health information to make health decisions. Individuals own and manage the information and maintained in a secure and private environment, with the individual determining rights of access”. The PHR passbook should have the following formats: Patient Identification Data, Health Summary, Child Development, Immunizations, Self care/treatments, Medications, Investigations, Hospitalization, Obstetric & Gynecology, Therapy, Chronic Disease (old age) , and Dental . Conclusion: Effective EHR at health institution level and PHR at personal level linking together and complementing each other will add value for accomplishing complete 360 degree information that would help providing comprehensive continuity of care, at right time, at right place and at right cost. This system will prevent duplication of investigations, medications, delay in care, check on risk and cost The 20th century has revolutionised the medical records system from outpatient cards to comprehensive unit records due to its important role played in effective healthcare delivery. The unit record system served almost the latter half of the 20th century. The theme of this paper is “Why PHR when EHR is the record of the future”. Examination of medical record system practiced in the last century will enlighten as to what type of medical records are required for the 21st century and beyond so that everyone will get swift, safe and good quality care at affordable cost. The physician needs comprehensive information to provide effective care, depending on the patient’s record that is not easily available as patient care information is scattered or disintegrated. A patient gets treatment at different health organisations, treats himself or uses other services such as herbal, unani, homeopathy or ayurveda. Despite the fact EHR is proved to be a great potential and the ‘record of future’, implementation difficulties due to lack of application of international standards like HL7, SNOMED-CT, LOINC, ICD, DIOCOM, NCPDP etc., are required to be fully interoperable. The PHR is defined as ‘a Health Passbook containing the identification data of a Person’, is a lifelong electronic, universally available document, initiated at the time of birth, containing, entire information such as episodic, hospitalisation, self medications and other habits including significant events, advance directives of living wills, organ donor authorisation, usually not available to care providers. This Health Passbook should have the patient identification data, health summary, child development, immunisation, self care/treatments, medications, investigations, hospitalisation, obstetric & gynecology, therapy, chronic disease (old age), and dental. Effective EHR at health institution level and PHR at personal level linking together and complementing each other will add value for accomplishing complete 360 degree information that will help provide comprehensive continuity of care at the right time, right place and at right cost. This system will prevent duplication of investigations, medications, delay in care, check on risk and cost. DOI: http://dx.doi.org/10.4038/sljbmi.v2i2.2246