Comments on: Bad Data & PHR Adoption

By: Nathan Lake

Nathan Lake — Fri, 24 Dec 2010 15:47:01 +0000

I like the CHR approach, but would argue that the PHR/EHR divisions are still relevant…at least in the eyes of the providers. Unfortunately, it is the physicians that seem to be hesitant to accept a close PHR/EHR integration. There is a widely held belief among many healthcare providers that patients can modify/edit data in the PHR in such a way that future recipients of that data will be unaware of the changes. While this may not be true with many of the PHRs, it is a reasonable fear considering the number of PHRs that have sprung up. With no standards to control their operation, there is nothing to prevent a PHR vendor form allowing it.

In my opinion, proper certification of PHRs is essential to alleviate those fears. It is the healthcare providers that will eventually make the PHR part of a true CHR…and right now, they are not universally on board.

There are widely accepted standards for EHRs being developed, but PHR stardards still lag behind…but we are working on them.

By: John

John — Fri, 24 Dec 2010 15:02:35 +0000

Nathan,
Thanks for your comment and you are correct, knowing where the data comes from and whether or not it has been altered is critical for trust, not only clinician trust in the data but patient/consumer trust as well.

While I have not been a big fan of certification initiatives, such as CCHIT’s for PHRs, there is a need for PHRs to clearly identify the source of PHI in a given PHR – is it clinician derived, patient derived, loved one etc. Such clear data tagging will help build trust on both sides of the current divide.

But more broadly speaking, believe the terms EHR, PHR, etc are artificial. THere is only one record, which we have begun calling a CHR, collaborative health record. Terms such as PHR, EHR create artificial divisions and are no longer relevant.

By: Nathan Lake

Nathan Lake — Thu, 23 Dec 2010 03:48:35 +0000

I am a member of the HL7 EHR, PHR and RM-ES (Records Management and Evidentiary Support) workgroups. Discussions there are now focusing less on accuracy and more on source control. There will always be inaccurate information in a patient’s EHR and PHR. Of course we need to do what we can to minimize inaccuracy, but it will always be there. What is more important (in my opinion and that of others) is that the source of the information be known to any reader/recipient. Mistrust by clinicians of PHR data is more closely tied to uncertainly of the data source than it is to questions of its accuracy.

If the recipient is able to reliably identify the source of the data, he/she is able to make a decision about how much trust they put on the data. Without knowing the source, the accuracy is a moot point since it almost certainly will not be trusted.

By: PHR Package & Reconcile | Beacon 16

PHR Package & Reconcile | Beacon 16 — Wed, 28 Jul 2010 21:13:29 +0000

[...] Bad Data & PHR Adoption « Chilmark Research. [...]

By: sanjaygidwani.net » Consider The Source

sanjaygidwani.net » Consider The Source — Sat, 12 Dec 2009 19:16:03 +0000

[...] addition, as John Chilmark points out ICD-9 is “limited” (full article). Problem is, claims data is based on limited code sets (ICD-9) that physicians use for [...]

By: Consider the Source

Consider the Source — Mon, 21 Sep 2009 19:04:27 +0000

[...] the PHR, if only billing data was used.In addition, as John Chilmark points out ICD-9 is "limited" (full article). Problem is, claims data is based on limited code sets (ICD-9) that physicians use for [...]

By: Tethered PHRs: Cutting the Umbilical Cord « Chilmark Research

Tethered PHRs: Cutting the Umbilical Cord « Chilmark Research — Wed, 13 May 2009 21:51:36 +0000

[...] While there has been some recent publicity on bad data that may exist in even a provider sponsored PHR, by and large the data therein is better and certainly more useful than what you’ll find in [...]

By: Health 2.0: A lot of Hot Air in This Balloon « Chilmark Research

Health 2.0: A lot of Hot Air in This Balloon « Chilmark Research — Mon, 27 Apr 2009 23:05:15 +0000

[...] Halamka and Roni Zeiger were very open and transparent as to what went wrong when e-Patient Dave tried to move his Personal Health Information (PHI) into Google Health. Halamka stated that it was a mistake to allow transfer of admin data, [...]

By: Bad Data Saga Continues « Chilmark Research

Bad Data Saga Continues « Chilmark Research — Wed, 15 Apr 2009 16:10:19 +0000

[...] 15, 2009 by John Since our post on Monday, where we highlighted the potential impact to PHR adoption of the Boston Globe story on one consumer’s less than ideal experience with Google Health, [...]

By: Jim

Jim — Tue, 14 Apr 2009 15:26:06 +0000

Added to EHRLinks.com