PHR and HIM: A Perfect Fit

Vol. 15 •Issue 4 • Page 20
PHR and HIM: A Perfect Fit

HIM professionals are well suited to be personal health record (PHR) advocates.

If you Google personal health records (PHRs), more than 14 million results come up, which proves PHRs are gaining popularity. With a new government focus on the electronic health record (EHR), it’s only natural for the PHR to garner more attention as well.

“The health care record medium is rapidly changing, but the management of the health information itself will always be needed,” assured Jill Burrington-Brown, professional practice manager, American Health Information Management Association (AHIMA). “And we [HIM professionals] are absolutely the ones who need to understand those mediums as we continue to manage health information.”

According to AHIMA, “HIM professionals serve the health care industry and the public by managing, analyzing and utilizing data vital for patient care—and making it accessible to health care providers when it is needed most.”

How Does the PHR Fit?

“I think HIM professionals should look at [the PHR] as an opportunity to expand their presence in the field,” explained Jeanne Donnelly, MBA, RHIA, associate professor at Saint Louis (MO) University.

MTs, coders, HIM directors, etc. are uniquely suited to lead the charge of the PHR. And Burrington-Brown explained why. “First of all, the HIM professional understands the management of health information better than anyone in the industry. We understand how the information is gathered, how it’s stored and where it is.

“That’s a key point because many patients, people who are not involved with health care on a regular basis, don’t know where to find the information. We are uniquely qualified to help find it for them and help explain what it is,” she stated.

And it’s important for HIM professionals to get a handle on this now.

Travis Bond, president of Bond Technologies, an administrative and technical services company for medical practice operations, explained, “Health care professionals need to recognize, as they plan for the future in terms of adopting new technology and implementing it at the user level, that the PHR is the other side of the EHR coin.”

C. Peter Waegemann, CEO, Medical Records Institute, agreed and offered his explanation of why the PHR is so appealing. “Patients cannot understand why their primary care facility (or other facilities) doesn’t collect all their health information. Granted, much of it may not be relevant, but a comprehensive patient record would improve the quality of care immensely because it would give the practitioner a complete overview of a person’s health history and bodily development,” he continued. “It is one of the reasons why millions of people are collecting copies of their records from providers and feeding them into their Web-based PHR.”

This is not to say the U.S. health care system has not tried to create a complete health record. In the early ’90s, the computer-based patient record (CPR) was attempted but failed, and now the more realistic approach of the EHR has taken shape, but it’s still in the works. And the rare EHR system that is up and running, “does not allow the interoperable, provider-independent health database necessary for seamless continued care across the range of medical specialties and the multitude of providers,” Waegemann explained.

So in the mean time, “it’s going to be the patient with the PHR who will create some of this interoperability,” assured Waegemann. And it’s going to be HIM professionals who help patients take this step.

“I think HIM professionals are qualified for this mainly because of our background and our educational experiences,” stated Donnelly. “We understand documentation and the importance of it in terms of providing better quality of care. Better documentation means better patient history will be available. I’m not sure there’s another profession out there that understands that link.”

Education Is Key

That’s why as educators, HIM professionals feel they’re responsible to educate the public.

“It’s our role as educators to be PHR advocates through the education programs,” stated Donnelly. “I think that’s one of the steps we see as necessary. We need to make the HIM profession aware of the emerging role.”

“As far as consumers go, I think there’s a very strong role for HIM professionals to educate the public about what their health information contains, how they access their records and the importance of having a PHR,” explained Kevin Gould, director of public relations, AHIMA.

Saint Louis University has been including the PHR in the HIM program for the last 4 years. A recent merger between the schools of allied health and nursing will provide opportunities for new initiatives and liaisons. “So we’ll push to include the PHR,” explained Julie Wolter, MA, RHIA, assistant professor at Saint Louis University.

Wolter and Donnelly recently completed research in Missouri on HIM professionals and their understanding of the PHR. The study’s findings were presented at AHIMA’s 2004 Annual Conference in Washington, DC.

“We found that there are a high percentage of HIM professionals who never heard of a PHR. And the fact that the people who should be doing the training haven’t taken the time to explore it, concerns us,” Donnelly explained.

Currently, two grants have been funded to continue research in Missouri and this February, Donnelly and Wolter will be talking to the physician group office managers.

“We’ll be talking about the PHR role in a physician practice. It’s exciting for us to be able to educate this group,” Wolter stated.

Physicians, nurses and every professional involved with health care has to be aware that the PHR is something they’ll see, and that it’s a truly accurate representation of the patient’s health.

Corporate Lends a Hand

National organizations and companies have even gotten involved. AHIMA has launched different programs in support of HIM professionals’ involvement with the PHR. They currently offer the Web site that provides information about health information rights, maintaining a PHR, patient flow of information, frequently asked questions and additional resources.

“In addition to, this year AHIMA will start to roll out a campaign where HIM professionals deliver community-based presentations to their local areas about what they need to know about PHRs,” Gould explained.

And AHIMA has also put together a group of 20 qualified individuals to research PHRs in one of its e-HIM groups. “I’m facilitating the PHR e-HIM group, and it’s running in this quarter. We’re planning to discuss if the PHR has been fully defined, how to educate consumers and HIM professionals, and what data elements should be included in a PHR,” added Burrington-Brown.

Another example of the PHR making its way into the mainstream is different trial runs of PHR programs.

Bond Technologies is planning to rollout a free PHR on a trial basis in Tampa, FL, health care facilities. “We want to see how many patients want to store their own health care files so they’ll be allowed to share that information or e-mail it at their discretion to other doctors.

“Creating a platform to play and experience this new kind of record will help with the acceptance of the PHR,” Bond assured.

Another trial is being run by the U.S. Surgeon General, the Centers for Disease Control and Prevention, and the Human Genome Project and involves a family health history form. Both Donnelly and Wolter were asked to participate.

“We’re going to be working on the public awareness of this form, which was kicked off last November. The organizations want to do something every year to raise awareness about maintaining your family history and how important it is genetically,” Wolter explained.

Donnelly added, “We’re really excited because we can see taking the project further and showing them the importance of the entire record.”

“As HIM professionals, we’ve always looked at the health record as a whole, while providers view it in pieces. We can clearly see how the PHR will help the provider and consumer in so many ways. It is now our job to educate them as to its importance,” Wolter stated.

A New Trend

Waegemann pointed out that because the PHR will affect everyone and is an important step toward an interoperable EHR, health care facilities need to come to terms with using PHRs. And he feels a great way to do that is to use the PHR as a marketing tool.

“Hospitals, clinics, etc. can use the PHR to bring patients, physicians and HIM professionals into their operation and use this advancement in technology to beat the competition of the hospital across town. Having a friendly, patient-centered PHR approach will attract professionals and consumers. It will help promise high-quality personal care.”

Tricia Cassidy is an assistant editor at ADVANCE.

Taking an Active Interest In Your Health Care

Patients today should keep track of their health care, rather than leaving matters of health to the medical profession. “And HIM professionals should start their own PHR to be a good example,” Waegemann explained.

This means that a responsible individual should:

• Have a copy of all of health information ever created by their providers.

• Understand, at least in general terms, the content of their health history.

• Use any resource to learn more about health matters that may affect them.

• Be a partner to the caregiver, rather than having a child/parent relationship with the caregiver.

Information provided by C. Peter Waegemann

One Size Fits All?

Not quite. There are various PHRs available and knowing the options and experiencing how they all work is important to the consumers’ comfort level. According to C. Peter Waegemann, CEO, Medical Records Institute, there are five types of PHRs:

• The off-line PHR is a paper-based or software-based patient record that’s been around for years, but it requires adding up-to-date records.

• The Web-based commercial/ organizational PHR is an Internet program that makes it possible to store one’s health information on a secure Web page.

• The functional/purpose-based PHR is a Web-based system that is offered in connection with a related service. The most common function is to provide emergency or health services to business people outside the geographic boundaries of their primary health care provider.

• The provider-based PHR is a system that providers (hospitals, clinics, etc.) make some of a patient’s health information available on the Web site.

• The partial PHR is a Web site that has detailed health information for consumers, and most likely it’s a disease-specific record.

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