Although the Internet age has improved American lives in many areas, researchers writing in the International Journal of Medical Engineering and Informatics say healthcare still lags behind. Use of a personal health record portal offers potential to gain ground – particularly in chronic disease management. 

Researchers Chif Umejei and Daniel Wiafe of the Department of Medical Informatics State University of New York, Brooklyn, say that self-management of chronic disease, such as diabetes, high blood pressure, cancer and COPD (chronic obstructive pulmonary disease) can improve patient health and reduce hospital visits. Disease management itself can be significantly improved by using current technological advancements such as the Internet and digitized personal health records, they say.

They point out that although PHRs have been used to store patient clinical history, coupling their use to disease management could make capable patients more active participants in their healthcare.

Currently, a PHR will contain the following information about a patient, which is usually accessible to healthcare workers and may also be available to caregivers and the patient themselves.

• Identification sheet - registration form with contact and insurance details
• Problem list - the patient's significant illnesses and operations
• Medication record - medicines prescribed and medication allergies
• History and physical - major illnesses and surgery, significant family history, health habits, and current medications; physician's findings on examination
• Progress notes - notes made by the healthcare workers on observations and treatment plans
• Consultation - healthcare worker opinions about health conditions
• Physician's orders - directions to other healthcare workers regarding medication, tests, diet, and treatment

Other entries might include X-ray and imaging reports, laboratory results, immunization records, consent forms and details of hospital visits.

For patients with a chronic disease, there is a need for continued patient education as well as ongoing documentation of symptoms, medication and side effects, the above summary of PHR opens up many possibilities for two-conversation between patient and healthcare workersm, say researchers. 

"With computer technology there is the opportunity to provide dynamic data communication and real-time patient education specifically at the point of care," the research team writes, noting that its survey of healthcare workers and patients suggests that demand for a PHR portal-type system would be high, yet no current implementations fulfill the various demands.

A healthcare portal that utilizes PHRs would improve the dialogue between patient and healthcare worker and so could improve patient health overall, the team concludes. Such an application "provides an opportunity to facilitate communications as well as make the consumer an active part in the management of their care."