Personal Health Record

Keywords: E-Accessibility, WCAG, Disabled people, Personal health record (PHR), Accessible electronic PHR (ePHR). 1 Introduction Personal health record (PHR) systems are widely used to maintain a dynamic and up-to-date health profile including a variety of different data that are not necessary limited to medical family history, medications, laboratory tests, diagnostic studies and vaccination, but may also contain lifestyle info, medication compliance, emotions, physical activity, etc. These records are intended to provide a complete and accurate summary of an individual's medical history in order to be useful, as well as (re)usable for clinicians and healthcare professionals to correctly evaluate the condition of a patient, without the need for time consuming and costly examinations. Thus, there exists significant value in making this information accessible online for all citizens, while complying with patient data privacy and security ethics.

For consumers (individuals), their caregivers and clinicians, a Personal Health Record (PHR) can be a valuable electronic tool for managing, storing and sharing health and medical information. The quality of healthcare can be improved when more complete health and medical information is available to caregivers and clinicians. Better informed consumers may be more engaged and able to make better health-related decisions through the use of information available in their PHR. When a consumer cannot give it, a PHR may provide treating clinicians with the important information they need in an emergency. A PHR also can provide caregivers with information they need to make healthcare decisions on a loved one’s behalf.

ployed in federated health care scenarios. This situation have been hindering the wide adoption of EHRs, con- tributing to delaying the establishment of a competitive market where contributions from different providers could take full advantage of information exchange and regular practitioners’ collaboration. Moreover, with the increasing awareness of medical subjects, patients are demanding more control over their own personal data - Personal Health Record (PHR). This paper presents a secure PHR repository which access is controlled through the joint use of a Virtual Health Card Service (VHCS) and an access Broker. This solution can be deployed in any public or private storage service since it behaves as a sandbox system which access pol- icy is defined externally. To assure a friendly query-retrieve interaction the whole repository is indexed, and separated clinical events are kept independently to increase the efficiency of cipher and encipher algorithms.

Keywords: personal health record, electronic health record, ındividual, health services. I. I ntroduction ersonal health records are broadly considered as means by which an individual’s personal health information can be collected, stored, and used for diverse health management purposes. In some concepts, the PHR includes the patient’s interface to a healthcare provider’s electronic health record (EHR). In others, PHRs are any consumer/patient-managed health record. This lack of consensus makes collaboration, coordination and policymaking difficult. It is quite possible now for people to talk about PHRs without realizing that their respective notions of them may be quite different. Recognizing the variety of attributes and possibilities and being very specific about what is being discussed would enable those engaged in collaboration and policymaking to conduct more nuanced discussions of PHRs and to collaborate more effectively.

CMS conducted a Personal Health Record Pilot called MYPHRSC for Medicare enrollees in South Carolina from 2009-2011 [115]. The PHR consisted of a web-based application from HealthTrio that provided users summaries of health information, medications, claims, calendars, and more. An outreach program contacted 100,000 Medicare beneficiaries in South Carolina and attempted to generate interest with demonstrations and adverts. The study conducted follow up surveys and interviews with beneficiaries. Overall, 4,114 beneficiaries registered and 3,041 used the PHR more than once. Pilot users expressed interest in the improved communication with providers, health summary information, and the printable wallet card with informa- tion on health, medications, and emergency contact. Even though the study focused on patients with chronic conditions, these users were not more likely to use the PHR. The lack of uptake among this group might have been caused by the short time period of the pilot and the lack of results tracking. Other cited issues were inaccurate claims data, usability issues, and lack of integration with beneficiaries’ workflows.

What is the Shared Care Plan? The Shared Care Plan is a free, easy-to-use, Personal Health Record that lets you keep track of vital health information in case of an emergency. You can also share this information with your family, physicians and other people you feel should have access to this information. For more information about the Shared Care Plan, please visit www.SharedCarePlan.org or call (360) 756-6840 or (888) 503-6843.

She highlighted the current debate about the choice between electronic patient records and personal health records, explaining the differences between the two. Patient records are mainly directed by the care provider, centrally organised and designed to couple health care systems. By contrast, personal health records are focused on the individual patient and access to the dossier is organised by the patient. The main difference underlying discussions about implementation of electronic patient records versus personal health records is thus about the mandate: should the individual patient be primarily responsible for the dossier, or should it be the care provider? One important question is to what extent patients are capable of managing and understanding all the information contained in their personal health record - capabilities vary across different groups within society. Ms Pluut did not advocate a specific choice but suggested that doctors and patients should engage in dialogue about the ways in which information is to be shared.

 The author proposed that,” Personal Health record management system is emerging patient centric model used for storing information on third cloud in encrypted format which is invisible for third party, And also to exchanging information which is stored on cloud. To ensure patients about storing information on cloud Attribute Based Encryption (ABE) technique is used.”

Abstract The purpose of this study was to assess the computer-use attitudes among chronically ill adult primary care practice (PCP) patients. The goal was to examine the rate of portal personal health record (PHR) use of middle-aged and older adults, to evaluate the effectiveness of an educational intervention in improving PHR adoption, and to identify patients’ thoughts about the PHR. The quasi-experimental, pre-test/post-test design with a paired matched set was performed with a convenience sample of 50 subjects from a primary care group practice in Central Florida.

In order to manage the increasing number of di- abetes disease in the future (13, 14) and reduce the workload of healthcare settings, there is the need to redefine the role of diabetes management organizations (15). Patients having more know- ledge about the disease and its process are more proficient during communication, thus acting as helpful assets in the long-term care (16). There- fore, a Web-based Personal Health Record (PHR) will serve as a useful tool in providing pa- tients with easy access to their health information (17-19).

Offline Alternatives Many of the benefits of having a compilation of your medical history can be enjoyed without posting the records online. The American Health Information Management Association offers suggestions on creating your own offline personal health record. The records can be stored on your own computer, on a USB or flash drive, or in a folder or binder. You can find information on their “MyPHR” site listed below. The Federal Drug Administration provides “My Medicine Record,” forms for keeping track of your

Cloud computing is used broadly in various services which maintain Personal Health Record (PHR). It is an emerging Health-centric model of patient health information interchange. Personal Health Record (PHR) information can be stored in a third party server i.e.Cloud server. The most important issues are fine–grained access, cryptographically enforced data access control, scalability in key management and efficient on-demand user revocation. We need to provide the security for the cloud based PHR information. This paper mainly concentrates on the multiple data owner scenario and divides the user into multiple security domains that significantly reduces the key management problems. A high level security of patient privacy is improved simultaneously by developing Multi-Authority Attribute Based Encryption (MA- ABE). We have a tendency to enhance the already existing format of PHR knowledge (template) into a secure format (PDF), GIF, DOC and set access privileges. Before taking a key to decrypt the PHR record in multiple owner scenarios it should raise some security questions on PHR owner.

Personal Health record was first mention and heard of in an article published by PubMed [2]. 1.2 BACKGROUND (PRIMARY CARE IT SOLUTIONS): 1.2.1 CARE SYSTEM STATUS These days most developing countries are introducing national health insurance programs and policies to ensure equality of the healthcare in their various countries. The insurance programs are design to ensure that people have adequate access to primary healthcare i.e. medically necessary hospitals, physician services and others. The healthcare system normally includes the provincial and territorial health insurance plans, all of which share common standard health coverage. Roles and responsibilities for a successful health care system are shared between the federal government, private practitioners, non-governmental organizations and others. Health insurance legislation, criteria and conditions are specified that must be satisfied and be met by all stakeholders of health providers.

Authenticating users in commercial smartphones is currently a naive process putting the smartphone owner in security risks in events such as unauthorized device sharing, device loss or theft, and session hijacking. With the recent interest of gov- ernmental and health organizations to provide their users with applications that can be run on their smartphones, securing these devices with measures above the cur- rent solutions is imperative. In this research, we propose a continuous authentication module for a Personal Health Record system that monitors its users for authenticity over time via their touch biometrics and denies access to those who can not satisfy authentication criteria.

An electronic personal health record for professional Iranian athletes is a comprehensive, secure and role- based instrument which ensures that only authorized individuals can gain access to confidential medical data according to their qualifications and rights. Secure role- based access maintains the confidentiality of patient in- formation and corresponds to standard medical privacy rules. The system can track the health of the athletes dur- ing their sport’s career and merge all related data that will be used and shared by medical staff, managers and researchers, across sport organizations and league com- petitions. This in turn provides the possibility of risk management, ensures the safety and competitive status of the athletes, allows customization of physical condi- tioning plans, and supports the aims of athlete, as well as league and sports organizations. The comprehensive electronic system includes work flows that are dedicated to instances such as clinical injury treatment, injury oc- currence analysis, acceptance of the athlete by the club, insurance management, and following instructions and the use of clinical instruments.

We are using cloud for personal health record data storage only in our system. 1.1 Framework overview in PHR: The main goal of this framework is to that provide security for accessing the data and management of data same time. The idea is divided the system into two parts i.e. public domain and private domain. Public domain consists of doctors, nurses and insurance companies. In personal domain user can give the authority for accessing or updating of data to its friend or closed relative.

7.3 Reflection When this research began in October 2008 at first the idea was to write the ideal business model for exploiting Personal Health Records on the Dutch healthcare market, however, during the research it became more and more clear that there is no exact ideal business model as there were too many variables based on choices, preferences and uncertainties in the market to give a one-way answer. As the Blue Ocean strategy already explains the market is very novel and the opportunities for Personal Health Records are still very open. We can also see this in practice in the different Personal Health Record products that are in existence today. This business model projects the opportunities that are available; it is up to the characteristics and choices of the company to decide which opportunities they favour above others. For instance Lifesensor uses a totally different revenue generation logic than Google Health as their management simply has different strategic views.

3 ecsec Gmbh, Sudetenstraße 16, 96247 Michelau, Germany {johannes.schmoelz,tobias.wich,detlef.huehnlein}@ecsec.de Abstract: An important future application of the German electronic health card (elektronische Gesundheitskarte, eGK) is the national Personal Health Record (PHR), because it enables a citizen to store and retrieve sensitive medical data in a secure and self-determined manner. As the stored data is encrypted with an eGK- specific certificate and retrieving the encrypted data is only possible after TLS- based authentication, the citizen needs to use a so called “PHR Citizen Client”, which allows to use the eGK for strong authentication, authorization, and decryption purposes. Instead of building such an application from scratch, this paper proposes to use the Open eCard App and its extension mechanism for the efficient creating of a PHR Citizen Client by developing an Open eCard Plug-in for accessing the German national Personal Health Record.

This functional analysis does not assume completeness on the function list of each category but rather provides a simplified yet comprehensive guide to evaluate the functionality of PHR systems, easily. 3.4. Architectural and Technical Requirements The last optional but desirable requirement is about architectural and technical decisions in the system's development process. The system's architecture should be carefully designed and the implementation should be based on state-of- ff the-art frameworks, in order to guarantee maintainability, expendability and interoperability. In the field of personal health record systems, there are three commonly used architectural models, the standalone, tethered and interconnected models [20, 21, 1]. Standalone PHR systems do not automatically interact with other electronic health record (EHR) systems, and patients are responsible for keeping them up to date. Tethered PHR systems are provided as part of a larger EHR system and are thus internally linked to a clinician-controlled health system. In tethered systems records can be transferred easily, within the system's infrastructure. Interconnected PHR systems are more sophisticated systems that support collaboration with other vendor's (EHR, EMR etc.) health systems. Due to their interconnection with other systems, they are able to collect data from multiple repositories and they serve as an external repository to which other health systems can connect.

The article reports on experiences in e-Health platforms and services for supporting medical research into the causes and relationships among physiological parameters and health problems concerning different chronic diseases. The Personal Health Record (PHR) is a way of standardizing electronic management of medical information between patients and their physicians, including medical bodies collaborating in providing integrated medical care services. We describe roles and aims behind electronic health records, follow with applicable legal and standardizations frameworks and relevant European activities, leading to the presentation of common commercial and open-source implementations of such systems, concluding with the indication of specific adaptations enabling a use of stored personal health data for scientific research into causes and evaluation of chronic illnesses. We describe ethical and privacy concerns that are relevant to using and exchanging electronic health information.