The 20th century has revolutionised the medical records system from outpatient cards to comprehensive unit records due to its important role played in effective healthcare delivery. The unit record system served almost the latter half of the 20th century. The theme of this paper is “Why PHR when EHR is the record of the future”. Examination of medical record system practiced in the last century will enlighten as to what type of medical records are required for the 21st century and beyond so that everyone will get swift, safe and good quality care at affordable cost.
The physician needs comprehensive information to provide effective care, depending on the
patient’s record that is not easily available as patient care information is scattered or disintegrated. A patient gets treatment at different health organisations, treats himself or uses other services such as herbal, unani, homeopathy or ayurveda. Despite the fact EHR is proved to be a great potential and the ‘record of future’, implementation difficulties due to lack of application of international standards like HL7, SNOMED-CT, LOINC, ICD, DIOCOM, NCPDP etc., are required to be fully interoperable.
The PHR is defined as ‘a Health Passbook containing the identification data of a Person’, is a lifelong electronic, universally available document, initiated at the time of birth, containing, entire information such as episodic, hospitalisation, self medications and other habits including significant events, advance directives of living wills, organ donor authorisation, usually not available to care providers. This Health Passbook should have the patient identification data, health summary, child development, immunisation, self care/treatments, medications, investigations, hospitalisation, obstetric & gynecology, therapy, chronic disease (old age), and dental.
Effective EHR at health institution level and PHR at personal level linking together and complementing each other will add value for accomplishing complete 360 degree information that will help provide comprehensive continuity of care at the right time, right place and at right cost. This system will prevent duplication of investigations, medications, delay in care, check on risk and cost.