Personal health record

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A personal health record, or PHR, is a health record where health data and information related to the care of a patient is maintained by the patient.[1] This stands in contrast to the more widely used electronic medical record, which is operated by institutions (such as hospitals) and contains data entered by clinicians or billing data to support insurance claims. The intention of a PHR is to provide a complete and accurate summary of an individual's medical history which is accessible online. The health data on a PHR might include patient-reported outcome data, lab results, data from devices such as wireless electronic weighing scales or collected passively from a smartphone.


The term "personal health record" is not new. The term was used as early as June 1978,[2] and in 1956, reference was made to a "personal health log."[3] The term "PHR" may be applied to both paper-based and computerized systems;[4] current[when?] usage usually implies an electronic application used to collect and store health data. In the early 2000s, healthcare industry organizations began to propose formal definitions of the term, for example:

The Personal Health Record (PHR) is an Internet-based set of tools that allows people to access and coordinate their lifelong health information and make appropriate parts of it available to those who need it. PHRs offer an integrated and comprehensive view of health information, including information people generate themselves such as symptoms and medication use, information from doctors such as diagnoses and test results, and information from their pharmacies and insurance companies.

— Markle Foundation's Personal Health Working Group, Connecting for Health (2003)[5]:3

The personal health record (PHR) is an electronic, universally available, lifelong resource of health information needed by individuals to make health decisions. Individuals own and manage the information in the PHR, which comes from healthcare providers and the individual. The PHR is maintained in a secure and private environment, with the individual determining rights of access. The PHR is separate from and does not replace the legal record of any provider.

— AHIMA e-HIM Personal Health Record Work Group (2005)[4]

The industry model personal health record (PHR) is a private, secure web-based tool maintained by an insurer that contains claims and administrative information. PHRs may also include information that is entered by consumers themselves, as well as data from other sources such as pharmacies, labs, and care providers. PHRs enable individual patients and their designated caregivers to view and manage health information and play a greater role in their own health care.

It is important to note that PHRs are not the same as electronic health records (EHRs) or electronic medical records (EMRs), which are software systems designed for use by health care providers.[5]:19–20[6] Like the data recorded in paper-based medical records, the data in EHRs are legally mandated notes on the care provided by clinicians to patients. There is no legal mandate that compels a consumer or patient to store her personal health information in a PHR.[citation needed]

PHRs can contain a diverse range of data, including but not limited to:

There are two methods by which data can arrive in a PHR.[1] A patient may enter it directly, either by typing into fields or uploading/transmitting data from a file or another website. The second is when the PHR is tethered to an electronic health record, which automatically updates the PHR. Not all PHRs have the same capabilities, and individual PHRs may support one or all of these methods.[1]

In addition to storing an individual's personal health information, some PHRs provide added-value services such as drug-drug interaction checking, electronic messaging between patients and providers, managing appointments, and reminders.[7]


PHRs grant patients access to a wide range of health information sources, best medical practices and health knowledge. All of an individual’s medical records are stored in one place instead of paper-based files in various doctors’ offices. Upon encountering a medical condition, a patient’s health information is only a few clicks away.

Moreover, PHRs can benefit clinicians. PHRs offer patients the opportunity to submit their data to their clinicians' EHRs. This helps clinicians make better treatment decisions by providing more continuous data.[1]

PHRs have the potential to help analyze an individual’s health profile and identify health threats and improvement opportunities based on an analysis of drug interaction, current best medical practices, gaps in current medical care plans, and identification of medical errors. Patient illnesses can be tracked in conjunction with healthcare providers and early interventions can be promoted upon encountering deviation of health status. PHRs also make it easier for clinicians to care for their patients by facilitating continuous communication as opposed to episodic. Eliminating communication barriers and allowing documentation flow between patients and clinicians in a timely fashion can save time consumed by face-to-face meetings and telephone communication. Improved communication can also ease the process for patients and caregivers to ask questions, to set up appointments, to request refills and referrals, and to report problems. Additionally, in the case of an emergency a PHR can quickly provide critical information to proper diagnosis or treatment.


Like other health information technology, PHR architecture of has three main components:

The information collected, stored, analyzed, and exchanged by the PHR.
Examples: medical history, laboratory results, imaging studies, medications
The platform that handles data storage, processing, and exchange.
Examples: stand-alone software programs or websites, provider- or payer-connected (tethered) websites
The information exchange, data analysis, and content delivery capabilities of the system.
Examples: scheduling appointments, medication refill or renewal, decision aids, and patient education materials.[8]

Various architectural models have different costs and benefits. Likewise, stand-alone, provider-tethered, and payer-tethered PHRs have different advantages and disadvantages for patients related to their individual circumstances. Such differences are among the priority areas in PHR research.[8] As PHRs may play key role in advancing health information exchange, interoperability with other health IT systems is an important consideration for PHR architecture.[8] If PHRs serve only as a repository for an individual’s health information, it is unlikely that individuals who are not highly motivated will maintain their health records and find PHRs to be useful.[citation needed]

Delivery platforms[edit]

One of the principal distinguishing features of a PHR is the platform by which it is delivered. The types of platforms include: paper, electronic device, and web.


Personal health information is recorded and stored in paper format. Printed laboratory reports, copies of clinic notes, and health histories created by the individual may be parts of a paper-based PHR. This method is low cost, reliable, and accessible without the need for a computer or any other hardware. Probably the most successful paper PHR is the hand-held pregnancy record, developed in Milton Keynes in the mid-1980s[9] and now in use throughout the United Kingdom. These include the Scottish Woman-Held Maternity Record,[10] All Wales Maternity Record,[11] and Perinatal Institute notes.[12]

Paper-based PHRs may be difficult to locate, update, and share with others. Paper-based PHRs are subject to physical loss and damage, such as can occur during a natural disaster. Paper records can also be printed from most electronic PHRs. However, Fawdry et al. have shown that paper records are extremely flexible and do have distinct advantages over rigid electronic systems.[13]

Electronic devices[edit]

Personal health information is recorded and stored in personal computer-based software that may have the capability to print, backup, encrypt, and import data from other sources such as a hospital laboratory. The most basic form of a PC-based PHR would be a health history created in a word-processing program. The health history created in this way can be printed, copied, and shared with anyone with a compatible word processor.

PHR software can provide more sophisticated features such as data encryption, data importation, and data sharing with health care providers. Some PHR products allow the copying of health records to a mass-storage device such as a CD-ROM, DVD, smart card,[14] or USB flash drive.[15]

PC-based PHRs are subject to physical loss and damage of the personal computer and the data that it contains. Some other methods of device solution may entail cards with embedded chips containing health information that may or may not be linked to a personal computer application or a web solution.

Web applications[edit]

Web-based PHR solutions are essentially the same as electronic device PHR solutions, however, web-based solutions have the advantage of being easily integrated with other services. For example, some solutions allow for import of medical data from external sources. Solutions including HealthVault, and PatientsLikeMe allow data to be shared with other applications or specific people. Mobile solutions often integrate themselves with web solutions and use the web-based solution as the platform.

A large number of companies have emerged to provide consumers the opportunity to develop online PHRs. Some have been developed by non-profit organizations, while others have been developed by commercial ventures. These web-based applications allow users to directly enter their information such as diagnosis, medications, laboratory tests, immunizations and other data associated with their health. They generate records that can be displayed for review or transmitted to authorized receivers.

Despite the need for PHRs and the availability of various online PHR providers, there has not been wide adoption of PHR services. In fact, Google, being among the most innovative companies in the world, discontinued its PHR service called Google Health on January 12, 2012. The reason cited for shutting down Google Health was that the service did not translate from its limited usage into widespread usage in the daily health routines of millions of people.[16][17] Surveys of web-based services have found wide variations in functions between services and only limited data on efficacy and safety concerns.[18][19][20][21] One analyst, describing the public's reluctance to adopt the services, called PHRs "a technology in search of a market."[17]

An emerging standard from HL7, Fast Healthcare Interoperability Resources (FHIR), is designed to make it easier for developers of personal health record applications to access relevant medical records.[22]

EHRs, PHRs, patient portals and UHRs[edit]

The terms electronic health records, personal health records, and patient portals are not always used correctly. The generally agreed upon definition of these terms relates mainly to the ownership of the data. Once data is in a PHR it usually owned and controlled by the patient. Most EHRs, however, are the property of the provider, although the content can be co-created by both the provider and patient. A patient has a legal right in most states to request their healthcare data and under recent USA legislation those providers using a certified EHR will be required to provide an electronic copy as well. In the UK, according to the governments's information strategy for the NHS every primary care practice in England will have to offer patients online access to their care records by 2015.[23] In 2012, only 1% did so.[24] Electronic health records and electronic medical records contain clinical data created by and for health professionals in the course of providing care. The data is about the patient but the data resides in a health care provider's system. The patient portal is typically defined as a view into the electronic medical records. In addition, ancillary functions that support a health care provider's interaction with a patient are also found in those systems e.g. prescription refill requests, appointment requests, electronic case management, etc. Finally, PHRs are data that resides with the patient, in a system of the patient's choosing. This data may have been exported directly from an EMR, but the point is it now resides in a location of the patient's choosing. Access to that information is controlled entirely by the patient.

A new concept being discussed is the UHR or "universal health record",[25] which would be a patient-centered and patient-controlled body of information that could be shared in a granular way with particular health care providers at the patient's discretion in support of the patient's work with health care providers. This project would enlist open source contributions and enhancements from developers, with particular emphasis on supporting patient expectations of privacy and responsible patient control of private health information (PHI). It is anticipated that effective implementation of one or more "open source" approaches to the UHR would benefit both providers and patients, including providing more cost-effective solutions to currently difficult problems including entry/verification/update of personal health data, enabling responsible patient-controlled granular release of PHI, and supporting interoperability and effective collaboration of patients and physicians across disparate EHR/PHR platforms.[citation needed]

While PHRs can help patients keep track of their personal health information, the value of PHRs to healthcare organizations is still unclear.[26]

In public health[edit]

PHRs have the ability to benefit the public health sector by providing health monitoring, outbreak monitoring, empowerment, linking to services, and research.[27] PHRs can give consumers the potential to play a large role in protecting and promoting the public's health.[28]

Barriers to adoption[edit]

Barriers to the adoption of PHRs include economic, technological, behavioral, and organizational issues, and barriers exist at both the environmental and individual levels.[1] Limited access to computers and Internet access among low-income populations, known as the digital divide, is one such barrier.[29]

Functional limitations[edit]

Despite the need to centralize patient information, PHR adoption has been very low. In 2002, a study was carried out in an effort to assess the functionality and utility of online PHRs. An abstraction from real-life case of a patient suffering from a thyroid condition was utilized to create various online PHRs. The outputs generated were examined for accuracy and completeness of clinical information. A team of researchers identified 19 websites offering different versions of PHRs. To evaluate the PHRs, researchers identified criteria based on their promotional advertisements. Ideally, centralized PHRs should help patients relate accurate history during clinical encounters, check for drug interactions, eliminate unnecessary duplication of laboratory tests and diagnostic studies, and serve as an information hub for patients’ health management.[30] An analysis of web-based PHR applications showed that most websites did provide access to personal medical information, however each demonstrated limited capacity in a different way:

From the 19 sites examined, four were found to be specific to certain diseases only and were therefore excluded from the study. Another four were excluded for reasons such as recurrent technical problems or connections to a specific hospital’s information system. The remaining 11 sites did not provide patients with sufficient guidance as to how they should enter personal data. Some of the sites allowed patients to select medical conditions from categorized lists which did not cover the patients’ complete health condition while others allowed free text entry. To formulate medication history, sites that required patients to choose medication from lists requested them to enter a wide range of descriptive information for each medication such as prescribed dose, administration frequency, start date, name of pharmacy that issued the medication and name of provider that prescribed the medication. With respect to laboratory tests, only two allowed patients to import results from outside sources. From these two sites, only one was functional. Not every site allowed patients to enter insurance coverage information. Majority of the sites required patients to enter date and results of diagnostic tests.[30]

Most people do not keep record of minute details of their healthcare experiences and therefore find it difficult to make use of web-based PHRs. Overall, the sites selected for evaluation offered limited functionality to the general public. Low adoption of web-based PHRs can be a direct result of limitations in these applications’ data entry, validation and information display methods. PHR development should be guided by ample patient-oriented research in future.


There are instances where the use of a PHR would be beneficial to patients and may, therefore, override privacy concerns. Stage 1 of meaningful use of certified EHR systems requires that practices provide at least 50 percent of their patients with a copy of their health records upon request. While this can be accomplished through a patient portal, this function can also be part of a larger system such as Kaiser Permanente's My Health Manager—a PHR that is integrated into the health system's patient portal. By June 2012, 3.9 million Kaiser members were enrolled in this program. For the first half of 2012, members viewed 2.5 million lab results, sent 1 million e-mails to physicians, and scheduled 230,000 appointments monthly, demonstrating ease of use and convenience.[31]

Privacy and security[edit]

One of the most controversial issues for PHRs is how the technology could threaten the privacy of patient information. Network computer break-ins are becoming more common,[32][better source needed] thus storing medical information online can cause fear of the exposure of health information to unauthorized individuals. In addition to height, weight, blood pressure and other quantitative information about a patient's physical body, medical records can reveal very sensitive information, including fertility, surgical procedures, emotional and psychological disorders, and diseases, etc. Various threats exist to patient information confidentiality:

Accidental disclosure
During multiple electronic transfers of data to various entities, medical personnel can make innocent mistakes to cause disclosure of data.
Insider curiosity
Medical personnel may misuse their access to patient information out of curiosity or for another purpose.
Insider subordination
Medical personnel may leak out personal medical information for spite, profit, revenge, or other purposes.
Uncontrolled secondary usage
Those who are granted access to patient information solely for the purpose of supporting primary care can exploit that permission for reasons not listed in the contract, such as research.
Outsider intrusion
Former employees, network intruders, hackers, or others may access information, damage systems or disrupt operations
Unlike paper-based records that require manual control, digital health records are secured by technological tools; three general classes of technological interventions can improve system security:[33][obsolete source]
These depend on the ethical behavior of people and include controls such as alerts, reminders, and education of users. Another useful form of deterrents has been Audit Trails. The system records identity, times, and circumstances of users accessing information. If system users are aware of such a record keeping system, it will discourage them from taking ethically inappropriate actions
Technological obstacles
These directly control the ability of a user to access information and ensure that users only access information they need to know according to their job requirements. Examples of technological obstacles include authorization, authentication, encryption, firewalls, and more.
System management precautions
This involves proactively examining the information system to ensure that known sources of vulnerability are eliminated. Examples of this would be the use of encryption or installing antivirus software in the system

Information security concerns surrounding PHRs extend beyond technological issues. There are also ethical issues affecting the transfer of personally identifiable information in the treatment process. Only gradually are architectural requirements and information-use policies becoming available such as the Privacy Rule under the U.S. Health Insurance Portability and Accountability Act (HIPAA).[34]

See also[edit]


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  5. ^ a b Personal Health Working Group (1 July 2003). Connecting for Health: A Public-Private Collaborative (PDF) (Report). Markle Foundation. Archived from the original (PDF) on 4 January 2007. 
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  9. ^ UK Department of Health (1993). Changing Childbirth, Part II: Survey of good communications practice in maternity services. London: HMSO. pp. 25–26. ISBN 0-11-321623-8. OCLC 925009321. 
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  12. ^ "About the notes". Perinatal Institute. Archived from the original on 17 May 2013. 
  13. ^ Fawdry, R; Bewley, S; Cumming, G; Perry, H (2011). "Data re-entry overload: time for a paradigm shift in maternity IT?". Journal of the Royal Society of Medicine. 104 (10): 405–412. doi:10.1258/jrsm.2011.110153Freely accessible. PMC 3184532Freely accessible. PMID 21969478. 
  14. ^ Kardas G, Tunali ET; Tunali (Jan 2006). "Design and implementation of a smart-card-based healthcare information system". Comput Methods Programs Biomed. 81 (1): 66–78. doi:10.1016/j.cmpb.2005.10.006. PMID 16356586.  (subscription required)
  15. ^ Wright A, Sittig DF; Sittig (2007). "Encryption Characteristics of Two USB-based Personal Health Record Devices". J Am Med Inform Assoc. 14 (4): 397–9. doi:10.1197/jamia.M2352. PMC 2244899Freely accessible. PMID 17460132. 
  16. ^ Brown, Aaron; Weihl, Bill (24 June 2011). "An update on Google Health and Google PowerMeter". The Official Google Blog. Google. Retrieved 19 December 2011. 
  17. ^ a b Lohr, Steve (2011-06-24). "Google Is Closing Its Health Records Service". The New York Times. ISSN 0362-4331. Retrieved 2016-12-10. 
  18. ^ Fernández-Alemán, José Luis; Seva-Llor, Carlos Luis; Toval, Ambrosio; Ouhbi, Sofia; Fernández-Luque, Luis (2013-11-13). "Free Web-based Personal Health Records: An Analysis of Functionality". Journal of Medical Systems. 37 (6): 9990. doi:10.1007/s10916-013-9990-z. ISSN 0148-5598. 
  19. ^ Menon, Shailaja; Singh, Hardeep; Meyer, Ashley N. D.; Belmont, Elisabeth; Sittig, Dean F. (2014-01-01). "Electronic health record-related safety concerns: a cross-sectional survey". Journal of Healthcare Risk Management: The Journal of the American Society for Healthcare Risk Management. 34 (1): 14–26. doi:10.1002/jhrm.21146. ISSN 2040-0861. PMID 25070253. 
  20. ^ Paton, C.; Hansen, M.; Fernandez-Luque, L.; Lau, A. Y. S. (2012-01-01). "Self-Tracking, Social Media and Personal Health Records for Patient Empowered Self-Care. Contribution of the IMIA Social Media Working Group". Yearbook of Medical Informatics. 7: 16–24. ISSN 2364-0502. PMID 22890336. 
  21. ^ Gartrell, K.; Trinkoff, A. M.; Storr, C. L.; Wilson, M. L.; Gurses, A. P. (2015-01-01). "Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health: A Cross-sectional Survey". Applied Clinical Informatics. 6 (2): 224–247. doi:10.4338/ACI-2014-11-RA-0107. ISSN 1869-0327. PMC 4493327Freely accessible. PMID 26171072. 
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  27. ^ Bower, JK; Bollinger, CE; Foraker, RE; Hood, DB; Shoben, AB; Lai, AM (2017-01-01). "Active Use of Electronic Health Records (EHRs) and Personal Health Records (PHRs) for Epidemiologic Research: Sample Representativeness and Nonresponse Bias in a Study of Women During Pregnancy". eGEMS (Washington, DC). 5 (1): 1263. doi:10.13063/2327-9214.1263. PMC 5340503Freely accessible. PMID 28303255. 
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  29. ^ Lober, WB; Zierler, B; Herbaugh, AL; Shinstrom, SE; Stolyar, A; Kim, EH; Kim, Y (2006), "Barriers to the use of a Personal Health Record by an Elderly Population", AMIA Annu Symp Proc, pp. 514–8, PMC 1839577Freely accessible, PMID 17238394 
  30. ^ a b Kim, Matthew; Johnson, Kevin (2002). "Personal health records: evaluation of functionality and utility". JAMIA. 9 (2): 171–180. doi:10.1197/jamia.M0978. PMC 344574Freely accessible. PMID 11861632. 
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Further reading[edit]


  1. Agarwal R, Angst CM (2006), "Technology-enabled transformations in U.S. health care: early findings on personal health records and individual use", in Galletta DF, Zhang P, Human-Computer Interaction and Management Information Systems: Applications, Advances in management information systems, 6 (illustrated ed.), Armonk, NY: M.E. Sharpe, pp. 357–378, ISBN 978-0-7656-1487-2, ISSN 1554-6152, OCLC 71890839 
  2. Lewis D, Eysenbach G, Kukafka R, Stavri PZ, Jimison HB, eds. (2005). Consumer health informatics: informing consumers and improving health care. Health informatics (illustrated ed.). New York: Science & Business Media. ISBN 978-0-387-23991-0. OCLC 898862674. 

Journal articles[edit]

  1. Kupchunas WR (May–June 2007). "Personal health record: new opportunity for patient education". Orthop Nurs. 26 (3): 185–91. doi:10.1097/01.NOR.0000276971.86937.c4. PMID 17538475. (Subscription required (help)). 
  2. "Readers' perspective: Personal health records will be widely used within five years, supplanting the need for regional health information organizations". Health Data Manag. 15 (10): 8. October 2007. PMID 17941305. (Subscription required (help)). 
  3. Ackerman MJ (September–October 2007). "The personal health record". J Med Pract Manage. 23 (2): 84–5. PMID 17974083. 
  4. Adler KG (2006). "Web Portals in Primary Care: An Evaluation of Patient Readiness and Willingness to Pay for Online Services". J Med Internet Res. 8 (4): e26. doi:10.2196/jmir.8.4.e26. PMC 1794005Freely accessible. PMID 17213045. 
  5. Burrington-Brown J, Fishel J, Fox L, et al. (June 2005). "Defining the personal health record: AHIMA releases definition, attributes of consumer health record". Journal of AHIMA. 76 (6): 24–5. PMID 15986557. 
  6. Albright B (February 2007). "Prepping for PHRs: The growing trend of consumer empowerment includes the speedy rise of personal health records". Healthcare Informatics. 24 (2): 44, 46. PMID 17370879. 
  7. American Health Information Management Association; American Medical Informatics Association (April 2007). "The value of personal health records: A joint position statement for consumers of healthcare by the American Health Information Management Association and the American Medical Informatics Association". Journal of AHIMA. 78 (4): 22, 24. PMID 17455841. 
  8. Atkinson NL, Massett HA, Mylks C, Hanna B, Deering MJ, Hesse BW (2007). "User-Centered Research on Breast Cancer Patient Needs and Preferences of an Internet-Based Clinical Trial Matching System". J Med Internet Res. 9 (2): e13. doi:10.2196/jmir.9.2.e13. PMC 1874719Freely accessible. PMID 17513284. 
  9. Burrington-Brown J, Friedman B (October 2005). "Educating the public about personal health records"Paid subscription required. Journal of AHIMA. 76 (9): 94–5. PMID 16274211. 
  10. Clarke JL, Meiris DC, Nash DB (2006). "Electronic personal health records come of age"Paid subscription required. American Journal of Medical Quality (Special Editorial). 21 (3 Suppl): 5S–15S. doi:10.1177/1062860606287642. PMID 16621927. 
  11. Conn J (10 July 2006). "Personal and (maybe) confidential: Questions over privacy, formats and definitions remain, but personal health records are on the way". Modern Healthcare. 36 (27): 28–31. PMID 16898550. 
  12. Cooke T, Watt D, Wertzler W, Quan H (May 2006). "Patient expectations of emergency department care: phase II--a cross-sectional survey". Canadian Journal of Emergency Medicine. 8 (3): 148–57. doi:10.1017/s1481803500013658Freely accessible. PMID 17320008. 
  13. Dorr D, Bonner LM, Cohen AN, Shoai RS, Perrin R, Chaney E, Young AS (2007). "Informatics Systems to Promote Improved Care for Chronic Illness: A Literature Review". J Am Med Inform Assoc. 14 (2): 156–63. doi:10.1197/jamia.M2255. PMC 2213468Freely accessible. PMID 17213491. 
  14. Einbinder JS, Bates DW (2007). "Leveraging information technology to improve quality and safety". Yearbook of Medical Informatics: 22–9. PMID 17700900. 
  15. Endsley S, Kibbe DC, Linares A, Colorafi K (May 2006). "An introduction to personal health records". Family Practice Management. 13 (5): 57–62. PMID 16736906. 
  16. Foxhall K (March 2007). "Now it's personal: Personal health records may be next on deck for the certification process". Healthcare Informatics. 24 (3): 30. PMID 17427793. 
  17. Friedman RH (2006). "Medicaid information technology architecture: an overview". Health Care Financ Rev. 28 (2): 1–9. PMC 4194978Freely accessible. PMID 17427840. 
  18. Greene J (September–October 2007). "The personal health record: a key to improving health care for seniors". AHIP Coverage. 48 (5): 46–8, 51–2, 55. ISSN 1551-8442. PMID 17941574. 
  19. Halamka JD, Mandl KD, Tang PC (2008). "Early Experiences with Personal Health Records". J Am Med Inform Assoc. 15 (1): 1–7. doi:10.1197/jamia.M2562. PMC 2274878Freely accessible. PMID 17947615. 
  20. Hassol A, Walker JM, Kidder D, et al. (November–December 2004). "Patient Experiences and Attitudes about Access to a Patient Electronic Health Care Record and Linked Web Messaging". J Am Med Inform Assoc. 11 (6): 505–13. doi:10.1197/jamia.M1593. PMC 524631Freely accessible. PMID 15299001. 
  21. Hess R, Bryce C, Paone S, et al. (October 2007). "Exploring challenges and potentials of personal health records in diabetes self-management: implementation and initial assessment"Paid subscription required. Telemedicine Journal and e-Health. 13 (5): 509–17. doi:10.1089/tmj.2006.0089. PMID 17999613. 
  22. Honeyman A, Cox B, Fisher B (2005). "Potential impacts of patient access to their electronic care records". Informatics in Primary Care. 13 (1): 55–60. doi:10.14236/jhi.v13i1.579Freely accessible. PMID 15949176.  open access publication – free to read
  23. Jossi F (February 2006). "Personal health records". Healthcare Informatics. 23 (2): 52, 54. PMID 16597007. 
  24. Kimmel Z, Greenes RA, Liederman E (November–December 2005). "Personal health records"Paid subscription required. J Med Pract Manage. 21 (3): 147–52. PMID 16471387. 
  25. Lafky DB, Tulu B, Horan TA (June 2006). "A user-driven approach to personal health records". Communications of the Association for Information Systems. 17: 46. ISSN 1529-3181. 
  26. Lee M, Delaney C, Moorhead S (October 2007). "Building a personal health record from a nursing perspective". Int J Med Inform. 76 (Suppl 2): S308–16. doi:10.1016/j.ijmedinf.2007.05.010 (inactive 21 September 2017). PMID 17616432. 
  27. Lin CT, Wittevrongel L, Moore L, Beaty BL, Ross SE (August 2005). "An Internet-Based Patient-Provider Communication System: Randomized Controlled Trial". J Med Internet Res. 7 (4): e47. doi:10.2196/jmir.7.4.e47. PMC 1550679Freely accessible. PMID 16236699. 
  28. McCarthy CP (May 2010). "Paging Dr. Google: Personal Health Records and Patient Privacy". William & Mary Law Review. 51 (6): 2243–68. 
  29. Moen A, Brennan PF (2005). "Health@Home: The Work of Health Information Management in the Household (HIMH): Implications for Consumer Health Informatics (CHI) Innovations". J Am Med Inform Assoc. 12 (6): 648–56. doi:10.1197/jamia.M1758. PMC 1294036Freely accessible. PMID 16049230. 
  30. Morales Rodriguez M, Casper G, Brennan PF (April 2007). "Patient-centered design: The potential of user-centered design in personal health records". Journal of AHIMA. 78 (4): 44–6. PMID 17455846. 
  31. Morrissey J (November–December 2005). "What does the public think? For consumers to adopt PHRs, they need reasons that hit home". Journal of AHIMA. 76 (10): 42–4. PMID 16333943. 
  32. Nelson R (September 2007). "The personal health record". American Journal of Nursing. 107 (9): 27–8. doi:10.1097/ PMID 17721144. (Subscription required (help)). 
  33. Pagliari C, Detmer D, Singleton P (August 2007). "Potential of electronic personal health records". BMJ. 335 (7615): 330–3. doi:10.1136/bmj.39279.482963.AD. PMC 1949437Freely accessible. PMID 17703042. 
  34. Pyper C, Amery J, Watson M, Crook C (November 2004). "Access to electronic health records in primary care-a survey of patients' views". Med Sci Monit. 10 (11): SR17–22. PMID 15507869.  open access publication – free to read
  35. Ross SE, Todd J, Moore LA, Beaty BL, Wittevrongel L, Lin CT (May 2005). "Expectations of Patients and Physicians Regarding Patient-Accessible Medical Records". J Med Internet Res. 7 (2): e13. doi:10.2196/jmir.7.2.e13. PMC 1550642Freely accessible. PMID 15914460. 
  36. Sax U, Kohane I, Mandl KD (May–June 2005). "Wireless Technology Infrastructures for Authentication of Patients: PKI that Rings". J Am Med Inform Assoc. 12 (3): 263–8. doi:10.1197/jamia.M1681. PMC 1090456Freely accessible. PMID 15684133. 
  37. Smith SP, Barefield AC (October–December 2007). "Patients meet technology: the newest in patient-centered care initiatives"Paid subscription required. Health Care Manag. 26 (4): 354–62. doi:10.1097/01.HCM.0000299254.29678.50. PMID 17992110. 
  38. Smolij K, Dun K (December 2006). "Patient Health Information Management: Searching for the Right Model". Perspect Health Inf Manag. 3: 10. PMC 2047307Freely accessible. PMID 18066368. 
  39. Tang PC, Lansky D (September 2005). "The missing link: bridging the patient-provider health information gap". Health Affairs. 24 (5): 1290–5. doi:10.1377/hlthaff.24.5.1290Freely accessible. PMID 16162575. 
  40. Weingart SN, Rind D, Tofias Z, Sands DZ (January–February 2006). "Who Uses the Patient Internet Portal? The PatientSite Experience". J Am Med Inform Assoc. 13 (1): 91–5. doi:10.1197/jamia.M1833. PMC 1380201Freely accessible. PMID 16221943. 
  41. Winkelman WJ, Leonard KJ, Rossos PG (May–June 2005). "Patient-Perceived Usefulness of Online Electronic Medical Records: Employing Grounded Theory in the Development of Information and Communication Technologies for Use by Patients Living with Chronic Illness". J Am Med Inform Assoc. 12 (3): 306–14. doi:10.1197/jamia.M1712. PMC 1090462Freely accessible. PMID 15684128. 
  42. Wright A, Sittig DF (February 2007). "Security threat posed by USB-based personal health records"Paid subscription required. Letters. Annals of Internal Medicine. 146 (4): 314–5. doi:10.7326/0003-4819-146-4-200702200-00020. PMID 17310061. 
  43. Wolter J, Friedman B (November–December 2005). "Health records for the people: Touting the benefits of the consumer-based personal health record". Journal of AHIMA. 76 (10): 28–32. PMID 16333941. 
  44. Woolf SH, Krist AH, Johnson RE, et al. (March–April 2006). "A Practice-Sponsored Website to Help Patients Pursue Healthy Behaviors: An ACORN Study". Annals of Family Medicine. 4 (2): 148–52. doi:10.1370/afm.522. PMC 1467008Freely accessible. PMID 16569718. 

Conference proceedings[edit]

  1. Lu SC (2007). "CCR exchange: building a patient-driven web-based healthcare community around an emerging personal health record standard". In Bos L, Blobel B. Medical and Care Compunetics 4Paid subscription required. Studies in Health Technology and Informatics. 127. pp. 58–64. ISBN 978-1-60750-250-0. PMID 17901599. 
  2. Kim E, Mayani A, Modi S, et al. (September 2005). "Evaluation of patient-centered electronic health record to overcome digital divide". Innovation from biomolecules to biosystems: proceedings of the 27th Annual International Conference of the IEEE Engineering in Medicine and Biology Society held on 1–4 September 2005 in Shanghai, China. Piscataway, NJ: IEEE. pp. 593–6. doi:10.1109/IEMBS.2005.1616482. ISBN 0-7803-8741-4. OCLC 4799129351. PMID 17282251. (Subscription required (help)). 
  3. Kun LG (September 2006). "Homecare and disease prevention: reviewing a decade of evolution — privacy still the biggest hurdle". Proceedings of the 28th Annual International Conference of the IEEE Engineering in Medicine and Biology Society held on 30 August – 3 September 2006 in New York, NY. Piscataway, NJ: IEEE. p. 4685. doi:10.1109/IEMBS.2006.259457. ISBN 1-4244-0032-5. OCLC 4799139453. (Subscription required (help)). 
  4. Poon EG, Wald J, Schnipper JL, et al. (2007). "Empowering patients to improve the quality of their care: design and implementation of a shared health maintenance module in a US integrated healthcare delivery network". In Kuhn KA, Warren JR, Leong T. MEDINFO 2007. Studies in Health Technology and Informatics. 129. pp. 1002–6. ISBN 978-1-60750-266-1. PMID 17911866. 
  5. Rocha RA, Romeo AN, Norlin C (2007). "Core features of a parent-controlled pediatric medical home record". In Kuhn KA, Warren JR, Leong T. MEDINFO 2007. Studies in Health Technology and Informatics. 129. pp. 997–1001. ISBN 978-1-60750-266-1. PMID 17911865. 
  6. Sachinopoulou A, Leppänen J, Kaijanranta H, et al. (August 2007). "Ontology-based approach for managing personal health and wellness information". Proceedings of the 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society held on 22–26 August 2007 in Lyon, France. Piscataway, NJ: IEEE. pp. 1802–5. doi:10.1109/IEMBS.2007.4352662. ISBN 978-1-4244-0787-3. OCLC 4801658634. PMID 18002328. (Subscription required (help)). 
  7. Wuerdeman L, Volk L, Pizziferri L, et al. (2005). "How Accurate is Information that Patients Contribute to their Electronic Health Record?". AMIA Annual Symposium Proceedings. 2005: 834–8. PMC 1560697Freely accessible. PMID 16779157. 
  8. Zeng-Treitler Q, Kim H, Goryachev S, Keselman A, Slaughter L, Smith CA (2007). "Text characteristics of clinical reports and their implications for the readability of personal health records". In Kuhn KA, Warren JR, Leong T. MEDINFO 2007. Studies in Health Technology and Informatics. 129. pp. 1117–21. ISBN 978-1-60750-266-1. PMID 17911889. 


  1. Angst CM, Agarwal R, Downing J (26 May 2006), An Empirical Examination of the Importance of Defining the PHR for Research and for Practice, Robert H. Smith School Research Paper (RHS-06-011), College Park, MD: Robert H. Smith School of Business, University of Maryland, doi:10.2139/ssrn.904611, SSRN 904611Freely accessible 
  2. California HealthCare Foundation (November 2005), National Consumer Health Privacy Survey 2005 (Survey), conducted by Forrester Research, Oakland, CA: California HealthCare Foundation 
  3. Markle Foundation (11 October 2005), Attitudes of Americans Regarding Personal Health Records and Nationwide Electronic Health Information Exchange (Survey), conducted by Public Opinion Strategies, New York: Markle Foundation 
  4. Personal Health Records: What Physicians Need to Know (PDF) (White paper). Texas Medical Association. April 2008. 
  5. Sprague L (30 November 2006). Personal health records: the people's choice? (PDF) (Issue Brief). Washington, DC: National Health Policy Forum, George Washington University. PMID 17146910. 820. Archived (PDF) from the original on 9 August 2017. 
  6. Glen Tullman (March 2010). "The benefits of an internet-based personal health record versus a paper-based personal health record is expected to grow rapidly within the next three years" (Interview). 

External links[edit]