PHR growing pains can be fixed.

The personal health record (PHR) is really facing some challenges now as the awareness of the value of the personal health record becomes known to the American public. What good does it do to sit in front of a computer and input medical information about yourself and your family and then have it coupled with data from a billing record when it is not accurate? People are starting to value their health information and billing information more and more. With the awareness of the Google Health products and their involvement, consumers are now more aware of the overall benefits of keeping a personal health record. But don’t be fooled, Google health products has had its share of headaches up to this point. It seems that we have so many choices with these products yet there are no standardizations measures of where the data comes from among any of them, on the clinical side or the administrative (billing) side.

As a consultant, I have seen some of the same issues with the electronic health record (EHR). I have seen where errors in the record constitute errors on the billing record or claim. One thing about the electronic health record (EHR) that is different from the personal health record (PHR) is that during the transitioning process, most consultants recommend that the health care facility or the providers fix their issues before they implement a large EHR system. Most consultants recommend that the issue of duplicate records be eliminated or at least be under control before implementing an EHR. Electronic Health Record systems typically only look at health information when they transition they do not necessarily couple this with billing information. Although most health centers do not review every record that is handed out, there is a formal record process for a hospitalized patient record. The hospital record has several built in steps to ensure that meets quality standards, assembled correctly, coded, billed and maintained properly. The same cleaning process needs to take place with the administrative data if it is going to be incorporated in to the personal health record side. Patients do not know to ask if there billing information is clean or not and they shouldn’t have to. The patient has the right to clean and accurate information on their clinical information and their administrative billing information.

When workflow processes are computerized this does not mean they are automatically accurate. This is the part of the puzzle that needs to be fixed just because we spend millions of dollars to implement the electronic health record or we ask that every patient be responsible for their own health care information by completing a personal health record, does not mean that we will NOT have problems. Garbage in is always equal to garbage out. If this data is not cleaned up in the paper medical record and on the claim or billing side with the insurance carrier, we will be wasting money if it is not standardized in some format. If everyone is not held accountable for their entries into the electronic health record or personal health record then we will be wasting money as well.

How do we fix the growing pains of the PHR? We start with educating the vendors so they are not selling products that are programmed to do more than they should be doing with valuable health care information. There are so many programmers being hired to just make the system work, that the people doing the actual work do not understand that health care information is different in one, how it is used and secondly how it is interpreted. Vendors should work closely with groups such as CCHIT to ensure standardization among personal health records. Vendors should work collaborately with other health care professionals on building a standardization format for the medical record so that it can be used easily with a personal health record. Another important step is to train medical personnel on what to down load on to a thumb drive/CD and what to give to a patient. It begins with education. We now need to switch roles and to train others to take more of an analyst approach to the record. We all need to become quality documentation experts in our own practice. Is there anyone auditing the final process or overseeing the results of the record? This needs to be built in. We cannot afford to sit and wait and become another Mr. DeBronkart who eventually discovered a problem: He found out that some of the information in his Google Health record was drawn from his billing record. His story really could have been a disaster. In the end, he had some good advice for others using a personal health record. He recommends that you check it, to see if it is accurate.

As a consultant, I feel that we are allowing too many hands in the pot. I am very concerned that there are too many people building EHR/PHR systems and they do not have the health information management background needed. I am not only scared for the patients but for the health care practitioners who practice.

Tags: consultant, Education, EHR, Google health record, health care, medical records, monitoring, Mr. DeBronkart, personal health record, PHR, tracking, training