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To Err is Human How Personal Health Records Can help

It seems that a day doesn’t go by without hearing about health information technology (HIT). The healthcare system often is touted as one of our nation’s worst big-industry offenders when it comes to implementing HIT. This lack of HIT is to blame for as many as 100,000 patient deaths each year caused by medical errors, according to a 1997 Institute of Medicine report. Many inefficiencies in healthcare also are attributed to the lack of HIT, such as redundant testing and massive amounts of paperwork, which contribute to the $1.6 trillion American’s spend on healthcare per year. With President Bush’s recent appointment of Dr. David Brailer as the National Coordinator for Health Information Technology, help is on the way. Four Strategies to Address HIT Deficiencies The National Health Information Infrastructure, which was unveiled by Dr. Brailer in Washington, D.C., last July identifies four key strategies that the federal government will pursue over the next 10 years to address the HIT deficiencies: bring electronic health records into clinical practice; connect clinicians with an interoperable data infrastructure; produce new consumer-centric information to help individuals make better choices in healthcare; and improve the overall health of the population. Personal health records (PHRs) are a core piece of the consumer-centric component, and they are critical to the overall HIT strategy. While many healthcare initiatives focus on the providers and payers of healthcare services, PHRs facilitate the involvement of the patient in becoming an active partner in the management, communication, and maintenance of their healthcare. And with less than 15% of providers having access to electronic health records, the patient’s involvement is critical to ensure accurate and timely care. According to a July 2004 report by the Markle Foundation, Connecting Americans to Their Healthcare, PHRs enable patients to: communicate and collaborate more effectively with doctors, pharmacists, and other healthcare professionals; better manage their healthcare, thus improving their health; improve efficiency, reduce duplication of tests, and quickly gain access to results; and improve the quality and safety of healthcare by using computers to identify possible problems. While the dissemination of PHRs is still in the early phase, research shows strong consumer interest and demand. In August 2004, Harris Interactive surveyed 2,500 Americans and found that two of five adults in the United States keep their own personal and family health records, 13% keep them electronically, and 40% plan to do so in the future. And, most importantly, 84% of all those surveyed welcomed the concept of personal health records. Opportunities For Improvement Pharmaceutical companies have the opportunity to reap many benefits from this growing industry. PHRs can improve patient compliance with medication adherence and refills, as well as improve prevention and early detection through automatic reminders. PHRs also can provide patient education in the context of the patients’ needs for their condition, medications, and available treatment options. For example, a patient may take a statin drug to reduce cholesterol. Like many drugs, some statins are metabolized by the cytochrome P-450 enzyme system and can cause drug-drug interactions when taken with multiple medications. PHRs can involve patients in treatment decisions by alerting them to potential problems with any new medication. Ultimately, these tools can be used in ways that benefit the companies that make pharmaceuticals by ensuring proper dosing, helping to avoid or manage adverse events, and alerting patients to drug-drug interactions. Furthermore, PHRs can help increase brand loyalty from both patient and provider through customization and continuous connectivity. But a note of caution: surveys also show that patients have some concern about the privacy and security of this information, with most survey respondents preferring to keep this information securely on their desktops or other storage devices. Several companies are leading the way in PHR technology. For example, CapMed, a division of Bio-Imaging Technologies Inc., offers solutions that include the Personal HealthKey and the Personal Health Record. The Personal HealthKey is a completely self-contained USB-enabled key-chain device that enables individuals to carry their complete medical records anywhere and to auto-launch user selected emergency information when plugged into any USB port. The Personal Health Record is a Quicken-like product that is housed on an individual’s desktop computer, enabling users to exchange information through a secure portal or printed reports. In summary, while healthcare technology continues to grow at a national level, there are numerous opportunities to leverage the critical role of the patient in the process. Larry J. Iaquinto is President and Chief Operating Officer of Interlink Healthcare Communications, Lawrenceville, N.J. Interlink is a full- service healthcare advertising and medical-education company. For more information, visit interlinkhc.com. PharmaVoice welcomes comments on this article. E-mail us at feedback@pharmavoice.com.

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