1. Personal Health Records: a systematic review 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 Biostatistics and Medical Informatics Department

2. Structure Introduction –Objectives Methods Results Discussion Conclusions

3. 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

4. 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.

5. What kind of information can a PHR contain? 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

6. 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

7. Objectives To evaluate the impact of PHRs’ utilization in the users’ health care.

8. Methods

11. Methods (participants)

12. 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: –Title, author, year and origin of the article; –Reviewer group; –Inclusion or exclusion; –Criteria not satisfied for exclusion.

13. 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

14. Results Systematic search: n = 364 Systematic search (after eliminating the repeated articles): n = 229 Articles included: n = 20 Percentage Inclusion: 8,7 % Exclusion: 69 % No abstract: 22,3%

15. Agreement Number of articles agreed / Total of articles read Mean (%): 90,2 %

16. Exclusion Legend: 1 – Does not respect both cirteria 2 – Does not present PHR’s evaluation of impact 3 – Does not present PHR’s definition

17. 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 personalHagland, 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 recordsLuo, 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 useLiaw, S.T. 1998 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

18. Discussion 10% of the articles