Towards the era of Precision Medicine: Personal Health Records
The battlefield: multimorbidity and polypharmacy
According to a report published by the World Health Organization (WHO), life expectancy has been risen over the past few decades, reaching the age of over 75 years in 60 countries worldwide; the risk of multimorbidity increases with aging, and likely results in polypharmacy (1).
Personal health records as a solution: definitions and types
Consumer health informatics is at the heart of healthcare in the age of precision medicine. It makes healthcare service possible, attainable, and effective if a system is designed properly with the right people to use. Particularly, a personal health record (PHR) is believed to be effective in accelerating the exchange, auditing, and management of diseases. The nature of PHR, which shifts the power and knowledge access towards patients, makes it ideal for a polypharmacy patient to take the responsibility of his/her health conditions.
A PHR is widely accepted as “an electronic application through which individuals can access, manage and share their health information, and that of others for whom they are authorized in a private, secure, and confidential environment” (3, 4). In other words, a PHR can accommodate patient-centered data, including hospital records, claim data, data from wearable devices, and lifestyles. The full coverage of one’s health data makes PHR a strong player when taking care of polypharmacy patients.
There are three kinds of PHR: 1) a standalone application whose content is solely patient-generated, 2) an application tethered with clinical databases, such as hospital or claim databases, with no functions for patient entry, and, 3) a tethered application with functions for patient-generated data. A PHR can be a web or mobile application. In caring for polypharmacy patients, limited evidence has suggested that PHRs are effective in medication management. Figure 1 illustrates some milestones of PHRs by governments and companies.
The best time for PHR to shine
Health is fundamental to life. Managing health should not add more pressure to patients, but be a process of convenience and efficiency. The fast-growing of treatment options already become a challenge for an ordinary person to perceive, not to mention older adults with complex medical conditions. Fortunately, in the 21st century, much of the healthcare data are now transformed into electronic formats; wearable devices and the Fast Healthcare Interoperability Resources (FHIR) adoption by the healthcare institutions are also being widely implemented, and as a result, this is the best time for PHR to shine.
Reference
1. World Health Organization. Multimorbidity. Technical Series on Safer Primary Care. 2016.
2. Wickramasinghe N. Essential Considerations for Successful Consumer Health Informatics Solutions. Yearb Med Inform. 2019;28(1):158–64.
3. Roehrs A, da Costa CA, Righi RD, de Oliveira KS. Personal Health Records: A Systematic Literature Review. J Med Internet Res. 2017;19(1):e13.
4. Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ. Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. Journal of the American Medical Informatics Association : JAMIA. 2006;13(2):121–6.
