open access - The Personal Health Record Paradox: Health Care Professionals

open access: JMIR--The Personal Health Record Paradox: Health Care Professionals’ Perspectives and the Information Ecology of Personal Health Record Systems in Organizational and Clinical Settings | Nazi | Journal of Medical Internet Research

Introduction

Personal health records (PHRs) are designed as tools to engage patients in their health care and to enable them to manage their personal health information [1-6]. Significant investments have been made by organizations to offer PHRs based on the desire to enhance patient-centered care [7-11], and the perceived potential for health care system improvement [12,13]. Historically, most PHR implementation efforts have focused on broad conceptions of consumer empowerment in which advocates emphasize the potential for PHRs to (1) increase consumer access to and control over health information, and (2) enable active patient participation in health care decision making and health management [14,15]. Despite high consumer interest in PHRs [16-21] and growing availability [22-25], a paradox exists in that adoption remains relatively low overall [26-28]. A national consumer survey conducted by the Markle Foundation revealed that only 10% of American adults currently use a PHR [29]. One notable exception to the low rate of PHR adoption is Kaiser Permanente: at the end of 2012, 4 million of its 9 million members had registered to use its patient portal, My Health Manager [30]. Among veterans, 71% utilize the Internet, and approximately one-fifth report using the US Department of Veterans Affairs (VA) PHR, My HealtheVet [31].....