JAMIA: How varied is PHR deployment in healthcare orgs?
Future policy activities, such as requirement specifications for the latter stages of meaningful use, should be leveraged as an opportunity to encourage standardization of functionality and broad deployment of personal health records (PHRs), according to an article published online Sept. 7 in the Journal of the American Medical Informatics Association.
Sarah A. Collins, RN, PhD, clinical informatics research and development at Partners HealthCare System in Wellesley, Mass., and colleagues aimed to understand the general use and functionality of PHRs and the organizational policies and decision-making structures for making data available to patients.
The cross-section survey was administered by telephone through structured interviews of 21 organizations to determine the types of data made available to patients through PHRs. This included the presence of explicit governance for PHR data release. Organizations were identified based on a review of the literature, PHR expertise and other sampling. Organizations that did not provide patients with electronic access to their data via a PHR were excluded.
According to the authors, interviews were conducted with 17 organizations for a response rate of 81 percent. Half of the organizations had governance in place, such as a written policy that outlined what data are available to patients. “Overall, 88 percent of the organizations used a committee structure for the decision-making process and included senior management and information services,” the researchers said, adding that all organizations sought input from clinicians.
The survey results indicated that organizations with internally developed systems had made fewer decisions for the release of clinical data elements compared with organizations with vendor systems: 51 percent vs. 78 percent. “However, organizations with internally developed systems withheld fewer data elements than vendor systems: 8 percent versus 15 percent. Additionally, of the systems that were operational for more than five years, 52 percent of the data elements were still not available and had no policy decision compared to 20 percent of the data elements for systems that had become operational within the last five years.
“A majority of the healthcare organizations that have implemented online PHR portals at this time generally appear to be institutions with sufficient financial, intellectual and human capital resources as evidenced by their ability to support internal development and maintenance, PHR governance, and continuing implementation and deployment efforts,” the authors concluded. “Broadly, many of the PHR policies are similar in nature, with variability at the level of data types made available and the methods and timing for release of that data. Future research is needed to determine best practices.”
To read CMIO's September cover story on PHRs, "PHRs at the Crossroads," click here.
Sarah A. Collins, RN, PhD, clinical informatics research and development at Partners HealthCare System in Wellesley, Mass., and colleagues aimed to understand the general use and functionality of PHRs and the organizational policies and decision-making structures for making data available to patients.
The cross-section survey was administered by telephone through structured interviews of 21 organizations to determine the types of data made available to patients through PHRs. This included the presence of explicit governance for PHR data release. Organizations were identified based on a review of the literature, PHR expertise and other sampling. Organizations that did not provide patients with electronic access to their data via a PHR were excluded.
According to the authors, interviews were conducted with 17 organizations for a response rate of 81 percent. Half of the organizations had governance in place, such as a written policy that outlined what data are available to patients. “Overall, 88 percent of the organizations used a committee structure for the decision-making process and included senior management and information services,” the researchers said, adding that all organizations sought input from clinicians.
The survey results indicated that organizations with internally developed systems had made fewer decisions for the release of clinical data elements compared with organizations with vendor systems: 51 percent vs. 78 percent. “However, organizations with internally developed systems withheld fewer data elements than vendor systems: 8 percent versus 15 percent. Additionally, of the systems that were operational for more than five years, 52 percent of the data elements were still not available and had no policy decision compared to 20 percent of the data elements for systems that had become operational within the last five years.
“A majority of the healthcare organizations that have implemented online PHR portals at this time generally appear to be institutions with sufficient financial, intellectual and human capital resources as evidenced by their ability to support internal development and maintenance, PHR governance, and continuing implementation and deployment efforts,” the authors concluded. “Broadly, many of the PHR policies are similar in nature, with variability at the level of data types made available and the methods and timing for release of that data. Future research is needed to determine best practices.”
To read CMIO's September cover story on PHRs, "PHRs at the Crossroads," click here.