Standards for Personal Health Records

In my post about Personal Health records , I identified the 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.

It's critical that Vendors, Payers, Providers and Employers embrace these standards. A standards-based personal health record can be used to prevent medication errors, ensure best practice disease prevention, and serve as the basis for decision support systems which recommend optimal care. Using CCD, data can be turned into wisdom , can be incorporated into EHRs, transmitted between PHRs, and can be easily expanded by the patient throughout life.

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.