An essential public health service function is to inform, educate and empower people about health issues.This has traditionally been accomplished through health educational resources such as brochures andvideos, media advocacy and social marketing, and health promotion program partnerships with communitybasedorganizations. However, public health messages and health promotion activities are increasinglydrowned out. Patients are increasingly able to access vast but often unreliable sources of medical andhealth advice online, and are bombarded by often contradictory health messages through the media. On-linepersonal health records offer the transformative potential of being able to personalize health education to theindividual patient's demographic characteristics, specifically age and gender, and medical conditions, alongwith decision support tools that can synthesize a great deal of medical knowledge into discrete andactionable recommendations. It also helps address the fragmented nature of our current healthcare systemallowing for improved health outcomes and patient-centered medicine.In Project 1, our goal is to inform the development of a model of the Personal Health Record (PHR) thatincorporates public health priorities and cognitive research to empower patients to access evidence-basedclinical preventive services. To this end, we will:1) Seek to understand the attitudes and beliefs held by consumers that influence general privacy andconfidentiality concerns; perceived benefits to and harm from health information technology; barriers anddrivers towards their use of a PHR; and their experience with access and utilization of a PHR;2) Conduct qualitative and quantitative evaluations of three large-scale implementations of PHRs in NewYork City. We will explore the meaning and purpose of each of the PHRs for patients, providers, andsponsoring institutions, describe the content requirements of a public health-oriented PHR, evaluate theusability of different formats, determine levels of consumer satisfaction and privacy concerns, assess theinfluence of the PHR on patient-provider communication, and determine the effects of the PHR on consumerknowledge and health seeking behavior. Using the results of the evaluations we will be able to provideconstructive suggestions for the format, content, and/or user interface of future iterations of PHRs.
| Diamond, Carol C; Mostashari, Farzad; Shirky, Clay (2009) Collecting and sharing data for population health: a new paradigm. Health Aff (Millwood) 28:454-66 |
| Mostashari, Farzad; Tripathi, Micky; Kendall, Mat (2009) A tale of two large community electronic health record extension projects. Health Aff (Millwood) 28:345-56 |
