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    Wednesday, 17 January 2018 10:12
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computerJune 8 2016

Everyone should be able to access their own health records online, but much more needs to be done to enable this, the Royal College of Physicians has proposed. Its new report calls for the development of patient health records (PHRs) as their potential contribution to improving service cost-efficiency and effectiveness is also not being met.

Limited data suggests there is current low level of usage both by individual and organisational users. “At best, there is only anecdotal information on PHR benefits, with little concrete evidence, and funding tends to be short term.” In addition, while there is support for their use, how people actually use them “is currently unclear, as are what data they want to see or which functions they are able to carry out using their PHR.”

The report was funded by NHS England with the research being carried out by the RCP’s Health Informatics Unit. It was commissioned to “undertake a landscape review of current personal electronic health and care record (PHR) activity in the UK” to inform NHS England’s strategy in this area.

It used the following definition of a PHR as being “a digital tool that helps people to maintain their health and manage their care. It may do this by enabling them to capture their own health and care data, to communicate with health and care services, and/or to have access to their care record.”

The study found that demographic factors such as age, gender, deprivation or ethnicity do not have a significant impact on PHR adoption or usage. However, they tend to be used at the moment “mainly by specific patient or citizen groups, especially those with long-term conditions who require regular monitoring and contact with health and care services.” They have also been implemented by individual organisations such as a hospital or GP practice, rather than by a care community.

Where PHRs are being used, most access is ‘view only’, and few organisations have made PHRs which can collate records from an individual’s personal health app or monitoring device, limiting the level of patient-generated data.
There is also limited sharing of PHR information between health professionals. “Surprisingly, we were unable to locate a significant implementation of shared records to support shared care anywhere in the UK, ie where patients/citizens and health/care professionals contribute to the same record within a shared patient pathway.”

However, PHRs are used significantly by patients to view blood test results, communicate with health professionals, and obtain further information about a condition or treatments, as well as book an appointment, request repeat prescriptions and view the history via Patient Online.

To help increase greater awareness of PHR access, the report identified a number of success factors, including:

• health and care professionals encouraging patients
• good communications through multiple channels and support for users at the start (eg demonstrating the use of PHR)
• involving patients and professionals throughout design, development and testing.

Professor Jeremy Wyatt, RCP Health Informatics Unit lead for new technologies, said: “Many people want to get more involved in managing their own health, but find it hard to do so without access to their data about their diagnoses, treatments, test results from their record, and information about what these all mean. Personal Health Records are a tool that can facilitate this, but at present are only available to restricted groups of patients.

“The evidence shows that more work is required to develop and improve the user experience, in order to better understand the wide variety of ways that people can use PHRs to support their own health, to increase uptake and usage of PHRs. However, this review provides key evidence on which the NHS can begin to build a case for investing in these technologies and innovations for the future.”

Links:

RCP announcement

RCP Personal health Record (PHR) final report

RCP Health Informatics Unit

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