UPM.MSHI.HI201: Blurred Lines

Personal Health Records (PHRs) really need a good, working evaluation rubric to guide lay users and health care professionals in selecting the best and suitable system. This I must seriously conclude after spending nearly more than twelve non-consecutive hours, scouring the Internet and exhausting all of Google’s search “tricks” to produce any information that could be used to critique PHR applications. Sadly, no rubric was ever found that could work with the assignment. There was a notable rubric, though, created in evaluating electronic medical records (EMRs), except that, after some considerable amount of study, I ended up deducing that PHRs behave and present information in much as the same manner as electronic health records (EHRs) and not like EMRs; hence, this rubric might not end up being helpful to the evaluation.

I had to contend now with making use of whatever else there is the net has on it. That leaves me with one particular evaluation framework proposed by Ali Sunyaev et al when they conducted a study in comparing Google Health against Microsoft HealthVault.

http://typo3-8442.rrz.uni-koeln.de/fileadmin/wiso_fak/wi_isq/pdf/HICCS_2010_Sunyaev.pdf

As for the PHR itself, I decided to pick up a random system from the list provided by myPHR.

I ended up choosing a PHR system that is currently in its infancy, as it seemed. The EMRy Stick (I decided to pronounce it like an acronym) Personal Health Record is an ePHR project by MDGuidelines that is currently in beta testing. The system has two versions - an online and an executable one - that have not yet been integrated into each other at the moment.

The executable version of the system consists of a working user interface which presents all of the contents in a tabular fashion. Once the file has been opened, an initial option window will show up enabling to choose which mode (Patient, Doctor, Emergency/EMT) will be used for the session. The mode can also be altered once inside the main interface during a session.

Inside, you can see all of the typical patient health information organized and presented neatly into nicely grouped tabs. Each tab has a distinct set of information contained in them, with all data arranged according to necessity. Most of the content of the PHR can normally be accessed through this manner with an additional way via the menu bar at the top.



The evaluation itself primarily consisted of a table where, originally, two PHRs were graded against each other to determine which one receives the greater scoring. I decided to pick up the evaluation framework itself to test it on the executable version of the system. And the results are as follows:

#	Description	EMRy Stick (Executable version)
		Rating	Comment
Patient Information
1	Patients should be able to access and view their medical records through a PHR system	3	Can create and edit one or more profiles.
2	Information in the PHR should up-to-date	2	Can only be as updated as how frequent user will make inputs on system.
3	Medical information should be presented in a cognitively accessible way	2	Easy navigation. Patients and doctors share same view.
4	Patients should be able to edit their medical records, annotate them or in the least request the responsible medical professionals to make corrections for them	3	All documents be edited, annotated, and deleted.
5	PHR should be technically accessible	2	Has both online and executable versions, though not integrated.
Personal Control
6	Each individual should control acces to their PHR	2	Profiles can be exported in a specific EMRy Stick file.
7	A possibility for an emergency access should exist	2	Emergency/EMT button present to access emergency medical data.
8	The individual should know who access their account and what actions were performed	1	Absent
Additional Services
9	Capturing cost information	3	Has a specific Expenses tab per profile where expense type, amount, and dates can be defined.
10	Document printing	2	Can indicate specific documents to print. Simple print view.
11	Secure messaging	1	Absent
12	Prescription refills	1	Absent
13	Appointment scheduling	1	Absent
14	Reminders	1	Absent
15	Notifications	1	Absent
16	Educational information	1	Absent
17	Support groups	2	Connected with Reed Group division, MDGuidelines.
18	Device integration	1	Absent
19	Decision support	1	Absent
20	Filing referral requests	1	Absent
21	Medicine information	1	Absent
22	Address book	3	Dedicated Contacts and Providers tabs for contact information on involved healthcare professionals and significant others
23	Quality comparisons	1	Absent
24	Localization	1	Absent
25	Searching	1	Absent
Legend: 1 – not available; 2 – partially available; 3 – fully available