Transcript 2nd Presentation

Personal Health Records:
a systematic review
Biostatistics and Medical
Informatics Department
Authors: Maria João Xará, Nivalda Pereira, Sandra Fontes, Anabela Maio,
Maria João Pinto, Cristina Gomes, Hugo Cunha Tiago Adrego, Paulo Pancrácio
Supervisor: Dr Ricardo Correia
Class 21
Structure
• Introduction
– Objectives
•
•
•
•
Methods
Results
Discussion
Conclusions
Introduction
Why PHR now?
There has been a tremendous progress in medicine as
well as in informatics during the last decades.
Haus, Reinhold; 2006
Recently there has been a remarkable upsurge in
activity surrounding the adoption of personal health
record (PHR) systems for patients and consumers.
Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ
What is a PHR?
PHR is a collection of important information
about individual’s health or the health of someone
he is caring for (such as a parent or a child) that
he actively maintains and update.
American Health Information Management Association, 2006
PHR is a medical historial made by the patient and that
is not controlled by the health professional.
PHRs systems are more than just static repositories for
patient data.
What kind of information can a PHR contain?
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Personal identification;
List and dates of significant illness and surgeries;
Current medications and dosages;
Immunizations and their dates;
Allergies;
Organ donor authorization;
Opinions of specialists;
Important test results;
Eye and dental records;
Any information that the user think is important for his health.
American Health Information Management Association, 2006
Why using PHR?
Potential Advantages
• Lower chronic disease management costs
• Lower medication costs
• Lower wellness program costs
Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ.; 2006
• To improve communication between the user and his providers
• To reduce or eliminate duplicate procedures or processes
Lawrence Gostin, JD;1997
Objectives
To evaluate the impact of
PHRs’ utilization in the
users’ health care.
Start
Primary search schoolar.google: “Personal Health Records”
Methods
Articles reading
Systematic search
Yes
Medline?
No
Query to Medline
Define query to SCOPUS
(“Patient Access to Records” [MeSH] and
“Medical Records Systems, Computerized”
[MeSH]) or (“Personal Health Records” or
“Personal Health Information”)
(“Patient Access to Records” and “Medical
Records Systems, Computerized”) or
(“Personal Health Records” or “Personal
Health Information”)
Apply the query
Apply the query
In English, French or
Spanish?
Yes
No
Common to both
searches?
Excluded
No
Yes
Eliminating the repeated articles
Start reading the abstract
Yes
Revisors agree?
No
3rd revisor
Yes
Included
The article respects all inclusion
criteria?
No
Excluded
Analysis of full-text
End
Start
Primary search schoolar.google: “Personal Health Records”
Articles reading
Systematic search
Yes
Medline?
No
Query to Medline
Define query to SCOPUS
(“Patient Access to Records” [MeSH] and
“Medical Records Systems, Computerized”
[MeSH]) or (“Personal Health Records” or
“Personal Health Information”)
(“Patient Access to Records” and “Medical
Records Systems, Computerized”) or
(“Personal Health Records” or “Personal
Health Information”)
Apply the query
Apply the query
Yes
In English, French or
Spanish?
No
Common to both
searches?
Excluded
In English, French or
Spanish?
Yes
No
Common to both
searches?
Excluded
No
Yes
Eliminating the repeated articles
Start reading the abstract
Yes
Revisors agree?
No
3rd revisor
Yes
Included
The article respects all inclusion
criteria?
No
Excluded
Analysis of full-text
End
Start
Methods
(participants)
n = 364
Common to both
searches?
Yes
Eliminate the
repeated one
No
Excluded
n = 135
Included
n = 229
Abstract analysis
n = 20
Included
n = 209
Excluded
Analisys of full-text
n=3
Included
n = 17
Excluded
End
Analysis’ strategy
• Groups of reviewers with 2 elements: 36 groups;
• Groups analysed between 6 and 8 abstracts;
• Results were expressed in Microsoft Excel which
includes:
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–
Title, author, year and origin of the article;
Reviewer group;
Inclusion or exclusion;
Criteria not satisfied for exclusion.
Analysis
Important information:
• Characteristics of the individuals
• Patient responsibility for the prevention or
intervention process
• Implemented system
• Users’ perception
• Health status of the user using the PHR
• Hospitalar services
Results
Systematic search
(after eliminating
the repeated articles):
n = 229
Systematic search:
n = 364
Articles included:
n = 20
Articles' selection
180
160
140
120
Number of 100
articles
80
60
40
20
0
158
Percentage
Inclusion: 8,7 %
Exclusion: 69 %
51
No abstract: 22,3%
20
Inclusion
Exclusion
Selection result
No abstract
Agreement
Agreement
120
100
100
83,3
80
66,6
Agreement (%) 60
57,1
50
40
20
0
23
7
3
2
1
Number of groups
Number of articles agreed / Total of articles read
Mean (%): 90,2 %
Exclusion
Articles' exclusion
160
151
140
120
100
Number of
80
articles
60
40
20
4
3
2
3
0
1
Exclusion criteria
Legend:
1 – Does not respect both cirteria
2 – Does not present PHR’s evaluation of impact
3 – Does not present PHR’s definition
Included articles
A new vision for maternity records in Scotland: the Scottish Woman-Held Maternity Record (SWHMR)
project and the electronic Scottish Woman-Held Maternity Record (eSWHMR) project.
Bedford H, Chalmers J.
2003
An introduction to personal health records.
Endsley S, Kibbe DC, Linares A, Colorafi K.
2006
Getting more personal
Hagland, M.
2001
Implementation of personal health records by case managers in a VAMC general medicine clinic.
Tobacman JK, Kissinger P, Wells M, Prokuski J, Hoyer
M, McPherson P, Wheeler J, Kron-Chalupa J, Parsons C,
Weller P, Zimmerman B.
2004
Making public health data available to community-level decision makers--goals, issues, and a case report.
Asaro PV, Land GH, Hales JW.
2001
Patient entry of information: evaluation of user interfaces.
Kim MI, Johnson KB.
2004
Patient participation in EHR benefits.
Jones TM.
2003
Patient experiences and attitudes about access to a patient electronic health care record and linked web
messaging.
Hassol A, Walker JM, Kidder D, Rokita K, Young D,
Pierdon S, Deitz D, Kuck S, Ortiz E.
2004
Personal health information management system and its application in referral management.
Wang M, Lau C, Matsen FA 3rd, Kim Y.
2004
Personal health records
Luo, J.S.
2006
Personal health records.
Kimmel Z, Greenes RA, Liederman E.
2005
Personal health records: an evaluation.
O'Flaherty S, Jandera E, Llewellyn J, Wall M.
1987
Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption.
Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ.
2006
Personal health records: evaluation of functionality and utility.
Kim MI, Johnson KB.
2002
Retention and use of personal health records: a population-based study.
Jeffs D, Nossar V, Bailey F, Smith W, Chey T.
1994
The South Australian personal health record: Determinants
of use
Liaw, S.T.
Towards personal health record: current situation, obstacles and trends in implementation of electronic
healthcare record in Europe.
Iakovidis I.
1998
Use of a patient-accessible electronic medical record in a practice for congestive heart failure: patient and
physician experiences.
Earnest MA, Ross SE, Wittevrongel L, Moore LA, Lin CT.
2004
Web-based personal health record systems evaluation
Win, K.T.
2006
Wireless technology infrastructures for authentication of patients: PKI that rings.
Sax U, Kohane I, Mandl KD.
2005
1998
Discussion
• 10% of the articles