Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care

<p>Abstract</p> <p>Background</p> <p>Integrated personal health records (PHRs) offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this potential and a framework for action to move them closer to the health care mainstream. This paper highlights and builds on the insights shared during the roundtable.</p> <p>Discussion</p> <p>While there is a spectrum of dominant PHR models, (standalone, tethered, integrated), the authors state that only the integrated model has true transformative potential to strengthen consumers' ability to manage their own health care. Integrated PHRs improve the quality, completeness, depth, and accessibility of health information provided by patients; enable facile communication between patients and providers; provide access to health knowledge for patients; ensure portability of medical records and other personal health information; and incorporate auto-population of content. Numerous factors impede widespread adoption of integrated PHRs: obstacles in the health care system/culture; issues of consumer confidence and trust; lack of technical standards for interoperability; lack of HIT infrastructure; the digital divide; uncertain value realization/ROI; and uncertain market demand. Recent efforts have led to progress on standards for integrated PHRs, and government agencies and private companies are offering different models to consumers, but substantial obstacles remain to be addressed. Immediate steps to advance integrated PHRs should include sharing existing knowledge and expanding knowledge about them, building on existing efforts, and continuing dialogue among public and private sector stakeholders.</p> <p>Summary</p> <p>Integrated PHRs promote active, ongoing patient collaboration in care delivery and decision making. With some exceptions, however, the integrated PHR model is still a theoretical framework for consumer-centric health care. The authors pose questions that need to be answered so that the field can move forward to realize the potential of integrated PHRs. How can integrated PHRs be moved from concept to practical application? Would a coordinating body expedite this progress? How can existing initiatives and policy levers serve as catalysts to advance integrated PHRs?</p

Foot-and-mouth disease:overview of motives of disease spread and efficacy of available vaccines

Control and prevention of foot and mouth disease (FMD) by vaccination remains unsatisfactory in endemic countries. Indeed, consistent and new FMD epidemics in previously disease-free countries have precipitated the need for a worldwide control strategy. Outbreaks in vaccinated animals require that a new and safe vaccine be developed against foot and mouth virus (FMDV). FMDV can be eradicated worldwide based on previous scientific information about its spread using existing and modern control strategies

The Citizen's Round Table process: canvassing public opinion on energy technologies to mitigate climate change

This study draws on communication accommodation theory, social identity theory and cognitive dissonance theory to drive a 'Citizen's Round Table' process that engages community audiences on energy technologies and strategies that potentially mitigate climate change. The study examines the effectiveness of the process in determining the strategies that engage people in discussion. The process is designed to canvas participants' perspectives and potential reactions to the array of renewable and non-renewable energy sources, in particular, underground storage of CO2. Ninety-five people (12 groups) participated in the process. Questionnaires were administered three times to identify changes in attitudes over time, and analysis of video, audio-transcripts and observer notes enabled an evaluation of level of engagement and communication among participants. The key findings of this study indicate that the public can be meaningfully engaged in discussion on the politically sensitive issue of CO2 capture and storage (CCS) and other low emission technologies. The round table process was critical to participants' engagement and led to attitude change towards some methods of energy production. This study identifies a process that can be used successfully to explore community attitudes on politically-sensitive topics and encourages an examination of attitudes and potential attitude change