Embracing a Health Services Research Perspective on Personal Health Records: Lessons Learned from the VA My HealtheVet System
- 769 Downloads
Personal health records (PHRs) are designed to help people manage information about their health. Over the past decade, there has been a proliferation of PHRs, but research regarding their effects on clinical, behavioral, and financial outcomes remains limited. The potential for PHRs to facilitate patient-centered care and health system transformation underscores the importance of embracing a broader perspective on PHR research.
Drawing from the experiences of VA staff to evaluate the My HealtheVet (MHV) PHR, this article advocates for a health services research perspective on the study of PHR systems.
We describe an organizing framework and research agenda, and offer insights that have emerged from our ongoing efforts regarding the design of PHR-related studies, the need to address PHR data ownership and consent, and the promotion of effective PHR research collaborations.
These lessons are applicable to other PHR systems and the conduct of PHR research across different organizational contexts.
Key wordspersonal health records health information health services research PHR
- 1.Committee on Quality Health Care in America, Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001.Google Scholar
- 7.Cronin C. Personal health records: an overview of what is available to the public. 2006. Available at: http://assets.aarp.org/rgcenter/health/2006_11_phr.pdf. Accessed Feb 28, 2009.
- 13.AHIMA e-HIM Personal Health Record Work Group. Defining the personal health record. J AHIMA. 2005;76(6):24–5.Google Scholar
- 14.Gearon C. Perspectives on the future of personal health records. 2007. Available at: http://www.chcf.org/documents/chronicdisease/PHRPerspectives.pdf. Accessed Feb 28, 2009.
- 19.Eytan T. Ending secrecy: physician makes case for full disclosure of health records. 2008. Available at: http://www.ihealthbeat.org/Perspectives/2008/Ending-Secrecy-Physician-Makes-Case-for-Full-Disclosure-of-Health-Records.aspx. Accessed Feb 28, 2009.
- 20.Greer C, Buck SL. PHRs and physician practices. J AHIMA. 2007;78(4):71–5.Google Scholar
- 23.Connecting for Health. Survey finds Americans want electronic personal health information to improve own health care. 2006. Available at: http://www.markle.org/downloadable_assets/research_doc_120706.pdf. Accessed Feb 28, 2009.
- 24.Harris Interactive. Two in five adults keep personal or family health records and almost everybody thinks this is a good idea. Health Care News. 2004;4(13). Available at: http://www.quickinsights.com/news/newsletters/healthnews/HI_HealthCareNews2004Vol4_Iss13.pdf. Accessed Feb 28, 2009.
- 25.Harris Interactive. Few patients use of have access to online services for communication with their doctors, but most would like to. 2006. Available at: http://www.harrisinteractive.com/news/allnewsbydate.asp?NewsID = 1096. Accessed Feb 28, 2009.
- 26.Connecting for Health. Americans overwhelmingly believe electronic personal health records could improve their health. 2008. Available at: http://www.connectingforhealth.org/resources/ResearchBrief-200806.pdf. Accessed Feb 28, 2009.
- 27.Connecting for Health. The personal health working group: final report. 2003. Available at: http://www.connectingforhealth.org/resources/final_phwg_report1.pdf. Accessed Feb 28, 2009
- 28.Brennan PF, Downs S, Casper G, Kenron D. Project HealthDesign: stimulating the next generation of personal health records. In: AMIA Annu Symp Proc; 2007:70–4.Google Scholar
- 29.Connecting for Health. Connecting consumers: a common framework for networked personal health information. 2006. Available at: http://connectingforhealth.org/commonframework/docs/P9_NetworkedPHRs.pdf. Accessed Feb 28, 2009.
- 30.National Committee on Vital and Health Statistics. Letter to department of Health and Human Services Secretary Michael Leavitt. 2005. Available at: http://www.ncvhs.hhs.gov/050909lt.htm. Accessed Feb 28, 2009.
- 33.Nazi K, Cowell F. My HealtheVet: VA’s new web-based tool helps veterans stay healthy-and involved in their care. PN. 2007;61(9):30–4.Google Scholar
- 34.Buxbaum P. Envisioning troop-centric health care. Government Health IT. 2008 Jun 8. Available at: http://www.govhealthit.com/print/4_18/features/350395-1.html. Accessed October 15, 2008.
- 35.Nazi K. “My HealtheVet Personal Health Record”, Testimony to AHIC CE Workgroup, September 12, 2007. Available at: http://www.dhhs.gov/healthit/ahic/materials/09_07/ce/nazi.html. Accessed October 15, 2008.
- 36.Nazi K. “My HealtheVet Personal Health Record, Part II”, Testimony to AHIC CE Workgroup, October 16, 2007. Available at: http://www.dhhs.gov/healthit/ahic/materials/10_07/ce/nazi.html. Accessed October 15, 2008.
- 37.MHV Program Office. My HealtheVet Product Intranet Website, Statistics. 2009.Google Scholar
- 38.MHV Program Office. My HealtheVet Product Intranet Website, IPA Statistics. 2009.Google Scholar
- 39.American Customer Satisfaction Index. ACSI methodology. 2006. Available at: http://www.theacsi.org/index.php?Itemid=41&id=48&option=com_content&task=view. Accessed Feb 23, 2009.
- 40.MHV Program Office. My HealtheVet Research Summary, September 2008.Google Scholar
- 41.Chumbler NR. Factors influencing implementation of My HealtheVet: final report for HSR&D project SHP 08-192. Washington, DC: Department of Veterans Affairs, Veterans Health Administration; 2008.Google Scholar
- 42.McInnes DK, Asch SM, Bokhour BG, et al. “My HealtheVet for Communication & Social Marketing,” Veterans Affairs Quality Enhancement Research Initiative (QUERI) National Meeting, Phoenix, AZ, December 12, 2008.Google Scholar
- 43.Weaver FM, Hogan TP, Smith BM, Wallen ES, Goldstein B, Hammond MC. Using the Web to promote self-management among veterans with spinal cord injuries. In: Congress of Spinal Cord Medicine and Rehabilitation Conference. Orlando, FL; 2008. Abstract available at: http://www.spinalcordcongress.org/pdf/Abstracts%20Final%202008.pdf. Accessed Feb 28, 2009.
- 44.Heidenreich PA. MHV: health status measure and quality of care assessment: rapid response project proposal 07-275. Washington, DC: Department of Veterans Affairs, Veterans Health Administration; 2008.Google Scholar
- 45.Glasgow RE, Linnan LA. Evaluation of theory-based interventions. In: Glanz K, Rimer BK, Viswanath K, eds. Health behavior and health education: theory, research, and practice. 4th ed. San Francisco: Jossey-Bass; 2008:487–508.Google Scholar
- 46.Wagner TH, Weingardt K. Supporting the evaluation of the My HealtheVet personal health record: rapid response project proposal 08-396. Washington, DC: Department of Veterans Affairs, Veterans Health Administration; 2008.Google Scholar
- 47.Office of the National Coordinator for Health Information Technology. US Department of Health and Human Services. Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information. 2008. Available at: http://www.hhs.gov/healthit/documents/NationwidePS_Framework.pdf. Accessed Mar 8, 2009.
- 48.Health Information Technology for Economic and Clinical Health Act (HITECH), Public Law 111-5, Section 13001 and following, 2009.Google Scholar