1. Using PHRs in the NHS Dr. Mohammad
Al-Ubaydli
Research evidence and best practices

2. A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
I was obsessed with handhelds...

3. A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
I was obsessed with handhelds...

4. A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
I was obsessed with handhelds...

5. A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
I was obsessed with handhelds... I’m serious!

6. A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
...and now it’s Personal Health Records

7. Some definitions
Clinicians Patient
Patient portals Personal health records
Electronic patient records Personal records

8. Some definitions
Clinicians Patient
Patient portals Personal health records
Electronic patient records Personal records
Data by clinicians for clinicians

9. Some definitions
Clinicians Patient
Patient portals Personal health records
Electronic patient records Personal records
Easing the patient’s burden
•scheduling appointments
•ordering medication refills
•secure messaging
•educational resources
•access to EPR
See: Pyper et al. 2004, Ralston et al,
2007.

10. Some definitions
Clinicians Patient
Patient portals Personal health records
Electronic patient records Personal records
Data by patient for patient
Powerful but unstructured
NHSmail users have mailbox shrunk
06 Feb 2008
NHS staff who use the health service’s email service NHSmail have been
informed that after a recent move to Microsoft Exchange their mailbox size
has been capped.
NHS accounts have been capped at just
Some 80% of
200Mb, which appears miserly compared with the hefty 6Gb offered
by Gmail for free, or the 5Gb offered for free on Windows Live
Hotmail.

11. Some definitions
Clinicians Patient
Patient portals Personal health records
Electronic patient records Personal records
Markle Foundation’s ideal PHR:
•Access controlled by patient
•Lifelong records
•Information from all
•Universal access
•Private and secure
•Transparent
•Easy exchange
See: Connecting for Health, 2004

12. Some definitions
Clinicians Patient
Patient portals Personal health records
Electronic patient records Personal records
What happens
when patient uses
these tools to take
control of their
health care?

13. Answer will be important for fixing current model
GP
NHS specialist A&E
Non-NHS clinicians
Clinicians Patient
Patient portals Personal health records
Electronic patient records Personal records

14. What if patient really was at the centre?
Clinicians Patient
Patient portals Personal health records
Electronic patient records Personal records

15. We don’t know but...
• Sharing information with patients is • Patient-held managment plans
good (Ros 2003) improve compliance and care
(Giglio 1978, Mellins 2000)
• Patients with chronic diseases
particularly benefit (de Clerq 2001) • Co-authorship between clinician and
patient creates accuracy and
concordance (Kaplan 2001)
• Interaction better than access
(Winkelman 2005)
• Giving patient decision-support
systems may bring major benefits
(Barry 1999, Brennan 1998, Leydon
2000)

16. Using PHRs in the NHS Questions?
me@mo.md
wiki.patientsknowbest.com