Benefits and Barriers for Adoption of Personal Health Records

A Personal Health Record (PHR) is an electronic, universally available, lifelong resource of health information maintained by individuals. There are numerous potential benefits to PHRs, including improved patient-provider relationships, increased patient empowerment, and enhanced care safety, efficiency, coordination, and quality. However, privacy, security, cost, and adoption issues have been significant barriers to implementation. The purpose of this research was to determine how the use of PHRs affects patient outcomes, as well as to analyze benefits and barriers of adoption of PHRs. The methodology for the examination of the benefits and barriers to PHR implementation was conducted following the basic principles of a systematic review. From a total of 144 initial references 76 sources were deemed suitable for use in this research study. A series of issues have been repeatedly listed as key barriers to the use of PHRs by patients and physicians including, privacy and security concerns, costs, integrity, accountability, and health literacy. PHRs have given control to the consumer and have provided patients with autonomy and empowerment. Full intent of functionality and use of PHRs will occur when patients and providers believe the information is safe, accurate, reliable and applicable for improving health

Achalasia: incidence, prevalence and survival. A population-based study

Studies of achalasia epidemiology are important as they often yield new insights into disease etiology. In this study, our objective was to carry out the first North American population-based study of achalasia epidemiology using a governmental administrative database.All residents in the province of Alberta, Canada receive universal healthcare coverage as a benefit. The provincial health ministry, Alberta Health and Wellness, maintains a central stakeholder database of patient demographic information and physician billing claims. We defined an achalasia case as a billing claim submitted for the years 1996–2007 with an ICD-9-CM code of 530.0 or 530 and a Canadian Classification of Procedure treatment code of 54.92A (endoscopic balloon dilation) or 54.6 (esophagomyotomy). A preliminary validation study of the case definition demonstrated a sensitivity of 85% and specificity of 99% for known cases and controls.A total of 463 achalasia cases were identified from 1995 to 2008 (59.6% males). Mean age at diagnosis was 53.1 years. In 2007, the achalasia incidence was 1.63/100 000 (95% CI 1.20, 2.06) and the prevalence was 10.82/100 000 (95% CI 9.70, 11.93). We observed a steady increase in the overall prevalence rate from 2.51/100 000 in 1996 to 10.82/100 000 in 2007. Survival of achalasia cases was significantly less than age–sex matched population controls ( P  < 0.0001).Using a population-based approach, the incidence and prevalence of treated achalasia is 1.63/100 000 and 10.82/100 000, respectively. The disease appears to have a stable incidence but a rising prevalence. Survival of achalasia cases is significantly less than age-matched healthy controls.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79287/1/j.1365-2982.2010.01511.x.pd