The Evolution, Use, and Effects of Personal Health Records: A Narrative Review

Abstract

Objective: To present a summarized literature review of the evolution, use, and effects of Personal Health Records (PHRs).

Methods: Medline and PubMed were searched for ‘personal health records’. Seven hundred thirty-three references were initially screened resulting in 230 studies selected as relevant based on initial title and abstract review. After further review, a total of 48 articles provided relevant information and were included in this paper. These articles were reviewed by one author and grouped into categories such as PHR evolution and adoption, patient user attitudes toward PHRs, patient reported barriers to use, and the role of PHRs in self-management.

Results: Eleven papers described evolution and adoption, 17 papers described PHR user attitudes, 10 papers described barriers to use, and 11 papers described PHR use in self-management. PHRs have evolved from patient-maintained paper health records to provider-linked electronic health records.  Patients report enthusiasm for the potential of modern PHRs, yet few patients actually use an electronic PHR.  Low patient adoption of PHRs is associated with poor interface design, and low health and computer literacy on the part of patient users.

Conclusion: PHR systems that account for patient’s needs and skills can facilitate their adoption. Common barriers are avoidable when patients receive adequate guidance on useful features as well as technical support. When implemented effectively, PHRs can increase patient participation in health management, and improve patient-physician communication and health related decision making when healthcare is provided in-person or at a distance.