Pediatric Informatics: Computer Applications in Child Health (Health ...

21 Personal Health Records 297
and cognitive disabilities, language barriers, low computer or reading literacy and
low health literacy.
PHR adoption is at an early stage in pediatrics, with current challenges of
establishing standards for content, information assurance and exchange as well as
overcoming many of the barriers to adoption of the technology.
21.5 Conclusion
Personal health records present a great opportunity for patient empowerment and
control of health information. Much attention has been given to their definition,
research and development, inclusive of child health, and standards for pediatric use
are still in development.
21.6 Case Studies: Examples of PHRS Planned
or Currently in Use (2007)
21.6.1 PHR in a Pediatric Office Practice
Pediatric Health Care at Newton Wellesley, Massachusetts 27
This small private group practice offers a PHR to families in their practice based
on a patient-carried USB drive. The practice uses the NextGen EHR 28 for medical
records and the CapMed PHR 29 with a special interface to transfer data between
the two systems. A single USB disk carries information about multiple family
members with the software that allows the system to be used on home computers or
on computers in hospitals and other physician offices. Information may be printed
prior to use when a computer will not be available. The system pre-populates the
PHR with information from the EHR and automatically updates it at each visit. The
PHR includes well child care patient education materials on the disk.
Benefits of this approach include: accurate and timely information from the
provider’s EHR, a single device for multiple children, encryption of data to prevent
exposure and easy recovery in the case of device loss and facilitated data collection
from home and office. An interface that allows capture of electronic prescribing
data facilitates medication reconciliation. Use of the technology is also perceived
as a marketing tool to build patient loyalty, especially for patients with complex
problems.
Challenges created by this approach include: the need for patients to bring their
USB device with them to each visit, problems with permissions and workflow
when providers new to the system first provide care for the patient, the costs associated
with the hardware and software. The system may not be appropriate for all
patients in the practice, but is popular with many.