EHR, PHRs, and is “Big Brother” Really Watching Us?

Sue Bergeson Health Guide
  • The abbreviations EHR and PHR are short for “Electronic Heath Record” and “Personal Health Record.” A great deal of work is being done at the government and private levels to create a standard electronic health record for all of us. The idea is to allow our doctors access to our information in any treatment setting—if I end up in the ER, if I get ill on vacation, when I go to my OB/GYN. In this way, treatment decisions can be made using all the information about me that may be critical to treatment; records can be standardized; and my health history can follow me from doctor to doctor. EHRs are designed to be very secure with extremely tight limits on those who can access the information.
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    For a more in-depth look at what has been going on in EHRs you may want to explore the American Health Information Management Association’s website at

    PHRs (Personal Health Records) are designed to allow us, the consumers, to record information that we feel is important and provide an ongoing record of our recovery journey. We can choose to share our PHRs with family and friends. PHRs can be used as wellness tools where we chart our moods; keep our recovery plans and tools; place our emergency plans and preferences online; and keep important contact information. PHRs can be recovery tools.

    For a more in-depth look at a mental health PHR, you may want to log onto one of the many Network of Care sites across the country.

    Recently DBSA did a survey of web visitors in preparation for a meeting around the topics of EHRs and PHRs. The findings were an interesting mix of thoughts, experiences, and ideas:  
    • 69% of respondents had trouble with their medical records in the past.
    • 69% have had to repeat their stories every single time they go to a doctor’s office.
    • 65% had to make multiple and escalating requests to see their own medical records. And 25% have still not been allowed to see them.
    Says one DBSA survey respondent:

    “I think it is a good idea to have the electronic medical records. I have recently been seen at a hospital for several different procedures in different departments. The same questions were asked in the different areas such as the X-ray department, OB/GYN department, MRI department, genetic testing department, oncology department, and psychiatric department.  My husband commented that they need to have the information...given one time and then the different departments would be able to access the information.”

    The points of highest interest to respondents include:
    • The ability for me to see what is in my record
    • The ability for me to correct information in my record
    • The ability for a new doctor to see the information written by an old doctor
    “Excellent idea, especially for those of us who are quite distraught or mentally unstable when admitted to the hospital and find it too hard to think and organize thoughts to give quality information to the doctor during a crisis. Do it, please! Put med. records into the electronic age/information age.” 

  • —DBSA survey respondent
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    Below are some of our survey respondents' greatest concerns:
    • I’m worried that the record will not be secure and that people I don’t want to see the record will be able to.•    I’m worried that people will be able to change my record without me knowing.
    • I worry that copies will be made. 
    • I think paper records are less likely to be lost.
    A concerned respondent states:

    “I am attempting to obtain a government security clearance, and I'm concerned that if my records were in electronic format, there would be a greater possibility that pieces of information about me might be released to either the government and/or private defense concerns without my prior consent or knowledge. I believe the potential for that happening to someone is much greater with electronic record-keeping then with the current system, and I have already seen my personal information (medically-related) released to others without my knowledge, much less my consent, and have lost a job opportunity on account of that having happened.”

    The end result of the survey was that, while there are concerns, 72% believe the benefits outweigh the problems.

    I have had bad experiences of not getting care because I was flagged in a hospital system as receiving psych care there before, but at my current hospital and with my current doctors, electronic medical records have worked in my favor. My primary doctor e-mails with me, and the open communication I have with him through e-mail has given me much better medical care than if I just saw him in office visits. Because my medical records are electronic with him, he has access to them from home and at his office and he can help me with anything not requiring a physical exam. Sometimes, when I email him with a question, I end up being sent to the ER, because it turns out that my symptoms were more serious than I thought. If I didn't have e-mail with my doctor, I would not have even mentioned them at all, yet it turns out to be something really serious needing medical attention.” 

    —DBSA survey respondent

    What are your thoughts about EHRs and PHRs?

Published On: March 21, 2007