The use of the PHI as a digital format went through three successive techniques starting with the Electronic Medical Record (EMR), then the Electronic Health Record (EHR), and finally the Personal Health record (PHR).
The first technique, Electronic Medical Record, is defined as ―a digital version of a paper chart that contains all of a patient’s medical history from one practice.
Electronic Medical Record (EMR)
An EMR is mostly used by providers for diagnosis and treatment. The problem with EMR is that it is hospital dependent and thus is very much similar to the paper-based technique of saving medical data.
The second technique, Electronic Health Record, is defined as “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. Estonia was the first country to implement the first nationwide Electronic Health Record (EHR) in the world, which was launched on December 17, 2008.
EHR has many advantages over EMR for the medical care specialist which can be different from one system to another. According to Centers for Disease (CDC) and Prevention’s National Center for Health Statistics survey of 2011 in USA, 85% of physicians are satisfied with their EHRs system, and 74% reported that EHRs enhanced their overall patient care. The largest integrated healthcare EHR in USA is VistA_EHR providing care to over 8 million veterans, employing 180,000 medical personnel and operating 163 hospitals, and over 800 clinics.
VistA_EHR is also implemented in Jordan (Oct. 2009) since it was proven as national-scale enterprise system capable of scaling to hundreds of hospitals. UK spends over $24 Billion to have all patients with a centralized electronic health record by 2010, but the program was dismantled after the high cost. Canada started the EHR system in 2004 under the name MyHealthAlberta for Alberta province allowing health professionals to view patient provincial medication profiles and a selection of local laboratory test results.
Since both EMR and EHR were run only by hospitals or medical specialists, patients have no access to their PHI outside hospitals in the majority of EHRs. Consequently, a new technique was found called Personal Health Record (PHR) defined as ―a set of computer-based tools that allow people to access and coordinate their lifelong health information and make appropriate parts of it available to those who need it.
Personal Health Record (PHR)
PHR is portable and is kept with the patient and contains medical lifelong information. It should not be restricted by file formats or other local issues. PHR gave the patient the ability to share their PHI with other medical care centres and the ability to control their record. However, patients’ PHI was still hard to be accessed in emergency situations. If the patient went in a comma, he/ she won’t be able to inform physicians where his/her PHR is located, and thus it is useless in such cases. According to a conducted survey in an ongoing research effort, more than 90% of physicians need more than five minutes to retrieve patient’s record, and 71% of targeted
physician says they did face situations like that and explained how hard it was to deal with such situations like that. Other examples of PHR are explained in related work.