November 24, 2012

No More Questions: Medical Health Records Enter the Digital Age

By Mary Romelfanger

"What medications are you currently taking"? "Please list all of the operations you have had in your lifetime." "How old were you when you had measles?" "When was the last time you had a tetanus shot?" "Are you allergic to any medications?"

Chances are that if you are 60 or older and have visited a physicians' office, dentist, clinic or hospital in the last year, you have had the sheer joy of responding to these and/or a multitude of other personal health history questions for at least the 25th time in your life. And, unless you are extremely well organized or have a knack for remembering events or dates (or events and dates in combination), you found yourself wracking your brain or searching through pockets or purses for a dog-eared piece of paper-the same behavior you experienced last year-to come up with reasonably close-to-correct responses.

But things are changing. The next time you walk into your healthcare provider's office, you could have all the answers to those crucial but tedious questions already in hand-on your Internet-capable communication device (smart phone, iPad, laptop, etc.). During the next few months, this column will address the rapidly emerging trends in electronic health data and how we can be more informed and better prepared consumers of healthcare services in this digital age.

Creating and Storing Personal Health Information in the Digital Age

There are two major digital systems for creating and storing personal health information: personal health records (PHR) and electronic health records (EHR).

PHR. As the name implies, a PHR is an electronic record of your entire health history-created and maintained by you. Paper forms of health history records have existed for many years, but maintaining and storing such records are fraught with problems because files can get lost, be difficult to retrieve and/or require extra storage space.

PHRs provide you with ownership of your health information and allow you to share information with multiple healthcare providers. You can create and store the records on your home computer and download them to a small storage device such as a thumb drive, or upload them to one of several websites. Many health insurance companies and medical information sites, such as WebMD and even, have PHR record-keeping options, which we will explore in more detail in a future column. A functioning model of such electronic information sharing, which patients can readily use, is the MyHealtheVet website, introduced by the U.S. Departent of Veterans Affairs (VA) in 2010 (Turvey). In a survey of 18,471 PHR users in the VA system, most respondents were interested in sharing access to their electronic health information with caregivers and non-VA providers (Zulman).

EHR. Electronic health records (also referred to as personal health record systems) refers to your health information that healthcare providers store-from physicians' offices to acute and long-term care facilities. How healthcare providers can quickly and securely access and share the essential information contained in these records have been topics of discussion for many years, and capable electronic systems are currently evolving. A major impetus in the development of EHRs was the 2010 Patient Protection and Affordable Care Act, commonly called the Affordable Care Act or Obamacare.

One of the more visible outcomes of this trend for better record-keeping, communication and quality of care tracking is replacing paper charts with electronic record systems in physicians' offices, hospitals, long-term care facilities and other health services delivery locations. Twenty-first century healthcare is now partnering with 21st century health information management. Mary Romelfanger, RN, MSN, CS (Gerontology), LNHA, is a clinical specialist with more than 30 years of experience working with the older adult population and healthcare systems throughout the United States and Canada.


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