హెల్త్ & మెడికల్ ఇన్ఫర్మేటిక్స్ జర్నల్

Standards and Guidelines for Personal Health Records in the United States: Finding Consensus in a Rapidly Evolving and Divided Environment

Abstract

Binh Q. Tran *,Pedro Gonzales

Health care spending in the U.S. over the past decade has dramatically increased over the past decade and is expected to rise to 20% of GDP in the United States by the end of the decade. In 2010, the U.S. Congress approved the Health Care Reform Act with a critical component of this legislation being the adoption of health information technologies (i.e. EMRs, EHRs, PHRs, etc.) aimed at transforming the health care system. Consumer-driven health care models are seen as essential to control the escalating costs of health care. The objective of this research is to canvas the landscape of existing standards and guidelines relating to electronic personal health records (PHRs) and to evaluate the level of adoption of these standards and guidelines amongst current vendors. Through this effort, we propose a consensus standard for PHRs consisting of 14 data components, 11 of which should be essential for all PHRs and 3 additional recommended data components. Through a survey of existing PHR vendors, we observe a low level of adoption of existing standards in commercially available PHR products and note a wide variation (36-73%) of inclusion of critical and desired data components. Further, we propose 4 key features and services based upon a review of the existing literature to facilitate consumer adoption and to improve usefulness of PHRs. By proposing a consensus standard for PHR data components and features, we seek to provide clarity to developers and vendors of HIT products to facilitate product development, interoperability, and integration and data exchange with existing EMR/EHR products