I have identified the four (4) major types of Personal Health records:
provider-hosted, payer-based, employer-sponsored and commercial. As
more products are offered, it's key that all the stakeholders involved
embrace national healthcare data standards to ensure interoperability
of the data placed in personal health records. To illustrate the point,
I am posting my entire lifelong medical record on my blog (this is with
my consent, so there are no HIPAA issues) in two ways. The first is a
PDF which was exported from a leading electronic health record system.
It's 77 pages long and contains a mixture of clinical data, administrative
data, normal and abnormal results, numeric observations, and notes.
It's a great deal of data, but is very challenging to understand, since
it does not provide an organized view of the key elements a clinician
needs to provide me ongoing care. It is not semantically interoperable,
which means that it cannot be read by computers to offer me or my
doctors the decision support that will improve my care. The second is
a Continuity of Care Document , using the national Health Information
Technology Standards Panel (HITSP) interoperability specifications.
It uses "Web 2.0" approaches, is XML based, machine and human readable,
and uses controlled vocabularies enabling computer-based decision support.
Today (December 13), HITSP will deliver the harmonized standards for
Personal Health Records, Labs, Emergency Records, and Quality measurement
to HHS Secretary Leavitt. These "interoperability specifications" will
become part of Federal contacting language and be incorporated into
vendor system certification criteria (CCHIT) over the next two years.