Functionalities and Issues in the Implementation of Personal Health Records: Systematic Review

Harahap, Nabila Clydea; Handayani, Putu Wuri; Hidayanto, Achmad Nizar

doi:10.2196/26236

Cited by 17 publications

(32 citation statements)

References 115 publications

(699 reference statements)

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“…The absence of established provincial standards for interoperability between systems hampered the integration of electronic PCMs in team-based care. In a review of personal health record functionalities and implementation, Harahap et al [ 44 ] identified interoperability as a key implementation issue, as well as security and privacy, usability, data quality, and personalization as other important factors. Digital health transformation at the system level is needed to realize interoperability, providing standard definitions for data exchange and cooperation with the patient, provider, and organizational systems.…”

Section: Discussionmentioning

confidence: 99%

Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach

Davis¹,

Antonio²,

Smith³

et al. 2022

JMIR Form Res

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Background Patient-centered measurement (PCM) aims to improve the overall quality of care through the collection and sharing of patient values, outcomes, and perspectives. However, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) offers a collaborative, adaptive approach to explore best practices for incorporating PCM into primary care practices by involving knowledge users, including patients and providers, in the exploratory process. Objective This study aims to test the feasibility of using patient-generated data in team-based care; describe the use of these data for team-based mental health care; and summarize patient and provider care experiences with PCM. Methods We conducted a multi-method exploratory study in a rural team-based primary care clinic using IKT to co-design, implement, and evaluate the use of PCM in team-based mental health care. Care pathways, workflows, and quality improvement activities were adjusted iteratively to improve integration efforts. Patient and provider experiences were evaluated using individual interviews relating to the use of PCM and patient portals in practice. All meeting notes, interview summaries, and emails were analyzed to create a narrative evaluation. Results During co-design, a care workflow was developed to incorporate electronically collected patient-generated data from the patient portal into the electronic medical record, and customized educational tools and resources were added. During implementation, care pathways and patient workflows for PCM were developed. Patients found portal use easy, educational, and validating, but data entries were not used during care visits. Providers saw the portal as extra work, and the lack of portal and electronic medical record integration was a major barrier. The IKT approach was invaluable for addressing workflow changes and understanding the ongoing barriers to PCM use and quality improvement. Conclusions Although the culture toward using PCM is changing, the use of PCM during care has not been successful. Patients felt validated and supported through portal use and could be empowered to bring these data to their visits. Training, modeling, and adaptable PCM methods are required before PCM can be integrated into routine care.

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Section: Discussionmentioning

confidence: 99%

Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach

Davis¹,

Antonio²,

Smith³

et al. 2022

JMIR Form Res

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“…Peffers et al [ 20 ] describe 6 activity-based methodologies for DSR, whereas Hevner et al [ 18 ] define 7 guidelines for DSR. This study follows the DSR guidelines defined by Hevner et al [ 18 ], which are grouped into 3 cycles or phases comprising the relevance cycle (identifying problems and the artifact type), design cycle (developing and evaluating the artifact), and rigor cycle (research contribution and communication; Figure 1 [ 5 ]). These guidelines have been followed by DSR studies in low- and middle-income countries to develop health information systems such as mobile health (mHealth) [ 19 , 21 - 27 ].…”

Section: Methodsmentioning

confidence: 99%

“…A previous review on the implementation of PHRs shows that PHR research has mainly been conducted in high-income countries rather than in low- and middle-income countries [ 5 ]. Few studies that have been conducted in low- and middle-income countries aim to propose PHR applications for certain purposes, such as pediatric vaccination [ 6 ], or specific diseases, such as metabolic syndrome management [ 7 ], chronic heart failure [ 8 ], and kidney transplant [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Integrated Personal Health Record in Indonesia: Design Science Research Study

Harahap¹,

Handayani²,

Hidayanto³

2023

JMIR Med Inform

Self Cite

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Background Personal health records (PHRs) are consumer-centric tools designed to facilitate the tracking, management, and sharing of personal health information. PHR research has mainly been conducted in high-income countries rather than in low- and middle-income countries. Moreover, previous studies that proposed PHR design in low- and middle-income countries did not describe integration with other systems, or there was no stakeholder involvement in exploring PHR requirements. Objective This study developed an integrated PHR architecture and prototype in Indonesia using design science research. We conducted the research in Indonesia, a low- to middle-income country with the largest population in Southeast Asia and a tiered health system. Methods This study followed the design science research guidelines. The requirements were identified through interviews with 37 respondents from health organizations and a questionnaire with 1012 patients. Afterward, the proposed architecture and prototype were evaluated via interviews with 6 IT or eHealth experts. Results The architecture design refers to The Open Group Architecture Framework version 9.2 and comprises 5 components: architecture vision, business architecture, application architecture, data architecture, and technology architecture. We developed a high-fidelity prototype for patients and physicians. In the evaluation, improvements were made to add the stakeholders and the required functionality to the PHR and add the necessary information to the functions that were developed in the prototype. Conclusions We used design science to illustrate PHR integration in Indonesia, which involves related stakeholders in requirement gathering and evaluation. We developed architecture and application prototypes based on health systems in Indonesia, which comprise routine health services, including disease treatment and health examinations, as well as promotive and preventive health efforts.

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“…According to the IN.2 of the PHR-S FM framework, a PHR system must support standards-based interoperability for seamless sharing of information between PHRs and other internal or external systems [ 48 ]. The same has been addressed in this study.…”

Section: Methodsmentioning

confidence: 99%

HL7 FHIR with SNOMED-CT to Achieve Semantic and Structural Interoperability in Personal Health Data: A Proof-of-Concept Study

Chatterjee

Pahari

Prinz

2022

Sensors

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Heterogeneity is a problem in storing and exchanging data in a digital health information system (HIS) following semantic and structural integrity. The existing literature shows different methods to overcome this problem. Fast healthcare interoperable resources (FHIR) as a structural standard may explain other information models, (e.g., personal, physiological, and behavioral data from heterogeneous sources, such as activity sensors, questionnaires, and interviews) with semantic vocabularies, (e.g., Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT)) to connect personal health data to an electronic health record (EHR). We design and develop an intuitive health coaching (eCoach) smartphone application to prove the concept. We combine HL7 FHIR and SNOMED-CT vocabularies to exchange personal health data in JavaScript object notion (JSON). This study explores and analyzes our attempt to design and implement a structurally and logically compatible tethered personal health record (PHR) that allows bidirectional communication with an EHR. Our eCoach prototype implements most PHR-S FM functions as an interoperability quality standard. Its end-to-end (E2E) data are protected with a TSD (Services for Sensitive Data) security mechanism. We achieve 0% data loss and 0% unreliable performances during data transfer between PHR and EHR. Furthermore, this experimental study shows the effectiveness of FHIR modular resources toward flexible management of data components in the PHR (eCoach) prototype.

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Functionalities and Issues in the Implementation of Personal Health Records: Systematic Review

Cited by 17 publications

References 115 publications

Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach

Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach

Integrated Personal Health Record in Indonesia: Design Science Research Study

HL7 FHIR with SNOMED-CT to Achieve Semantic and Structural Interoperability in Personal Health Data: A Proof-of-Concept Study

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