Personal Health Record (PHR)

Article Author:
Dhruv Sarwal
Article Editor:
Vikas Gupta
Updated:
5/30/2020 2:01:58 PM
PubMed Link:
Personal Health Record (PHR)

Definition/Introduction

A personal health record (PHR) refers to a compendium of an individual's personal details as relevant to their health and which assists in the provision of tailored medical care to them.[1] The person themselves maintains this collection of data or a caregiver in cases where the person is unable to do so on their own. This approach is in contrast to electronic health records (EHR), which are maintained by hospitals or clinics and used for providing medical care as well as billing purposes.

This record may be physical or electronic and includes all self-reported and self-recorded health data, including health issues, medications taken by them, records of vital signs and activity recorded with personal devices including smartphones and smartwatches, nutritional data such as diet composition and calorie intake, and so on.

The goal of a PHR is for the patient to be able to keep their health data on hand for ready access for both themselves and anyone involved in their care while maintaining the privacy and security of this data.

Issues of Concern

Benefits of PHR platforms include [2]:

  • A snapshot view of a person's health
  • Objective data points for vital signs, nutrition, physical activity, and disease course
  • Greater clarity of medications to be taken and better compliance with these, plus an improved assessment of the same
  • Identification of successes and failures in the delivery of care and the underlying reasons for these
  • Quicker emergency responses and availability of health data in the absence of a caregiver or bystander

Potential pitfalls include [2]:

  • A one-size-fits-all approach that may not take into account individual variations
  • Untested sensitivity and specificity of different platforms
  • The anxiety provoked by an urge to record all personal data and to find patterns where none exist
  • Bias in self-reporting where applicable
  • Lapses in security and confidentiality especially with cloud-based solutions

Clinical Significance

PHRs are seeing widespread adoption in today's digital age, and physicians must adapt to this new source of data. Interpreted correctly, a PHR can provide valuable data points to assess the clinical course of a problem before the presentation and provides a level of fidelity that could not be achieved by oral history. This concept represents a crucial component of shared decision making by the patient and their physician.[3]

However, critical analysis is necessary, as many of these devices and applications use one-size-fits-all algorithms that may result in both false positives and false negatives in the interpretation of medical conditions.

Nursing, Allied Health, and Interprofessional Team Interventions

Allied health providers can significantly contribute to the development of individual PHRs by counseling and educating persons to the benefits and shortcomings of various platforms, the relevance of data recorded to their clinical problems, and by filtering information and reducing noise in this data to make interpretation easier for the physicians involved in the patient's care.


References

[1] Tang PC,Ash JS,Bates DW,Overhage JM,Sands DZ, Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. Journal of the American Medical Informatics Association : JAMIA. 2006 Mar-Apr;     [PubMed PMID: 16357345]
[2] Roehrs A,da Costa CA,Righi RD,de Oliveira KS, Personal Health Records: A Systematic Literature Review. Journal of medical Internet research. 2017 Jan 6;     [PubMed PMID: 28062391]
[3] Davis S,Roudsari A,Raworth R,Courtney KL,MacKay L, Shared decision-making using personal health record technology: a scoping review at the crossroads. Journal of the American Medical Informatics Association : JAMIA. 2017 Jul 1;     [PubMed PMID: 28158573]