Background: Integrated personal health records (PHRs) offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this potential and a framework for action to move them closer to the health care mainstream. This paper highlights and builds on the insights shared during the roundtable.

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On April 15, 2010, patient safety experts were assembled to discuss the adequacy of the public policy response to the Institute of Medicine report ''To Err is Human'' 10 years after its publication. The experts concluded that additional government actions should be considered. Actions that deserve consideration include the development of an educational campaign to improve public and provider understanding of the issue as a means to support change similar to successful public health campaigns, support the evolution of payment reform away from fee for service, create a clearer aim or goal for patient safety activities, support the development and use of better safety measures to judge status and improvement, and support for additional learning of what works particularly on implementation issues.

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Health information technology (HIT) is the underpinning of a vision for the future of American medicine that is gaining consensus among public and private policymakers nationwide. As envisioned today, Americans will one day experience a health care system in which disparate providers across an otherwise fragmented delivery system will share health records in real time by means of a national network of electronic medical record systems. The architects drafting the IT blueprints for an interconnected electronic health infrastructure represent a public-private partnership that is actively paving the way toward what the Bush Administration calls the "decade of health information technology.

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