Institute of Global Health Innovation, Imperial College London, London, UK
Institute of Global Health Innovation, Imperial College London, London, UK.
BMJ Open. 2019 Sep 18;9(9):e029582. doi: 10.1136/bmjopen-2019-029582.
This article reflects on the changing nature of health information access and the transition of focus from electronic health records (EHRs) to personal health records (PHRs) along with the challenges and need for alignment of national initiatives for EHR and PHR in the National Health Service (NHS) of the UK. The importance of implementing integrated EHRs as a route to enhance the quality of health delivery has been increasingly understood. EHRs, however, carry several limitations that include major fragmentation through multiple providers and protocols throughout the NHS. Questions over ownership and control of data further complicate the potential for fully utilising records. Analysing the previous initiatives and the current landscape, we identify that adopting a patient health record system can empower patients and allow better harmonisation of clinical data at a national level. We propose regional PHR 'hubs' to provide a universal interface that integrates digital health data at a regional level with further integration at a national level. We propose that these PHR hubs will reduce the complexity of connections, decrease governance challenges and interoperability issues while also providing a safe platform for high-quality scalable and sustainable digital solutions, including artificial intelligence across the UK NHS, serving as an exemplar for other countries which wish to realise the full value of healthcare records.
本文反思了健康信息获取性质的变化,以及关注点从电子健康记录 (EHR) 向个人健康记录 (PHR) 的转变,同时还探讨了英国国民保健制度 (NHS) 中 EHR 和 PHR 国家计划的调整的挑战和必要性。实施集成 EHR 以提高医疗服务质量的重要性已逐渐被理解。然而,EHR 存在一些局限性,包括 NHS 内多个提供商和协议导致的严重碎片化。对数据的所有权和控制权的质疑,进一步使充分利用记录的潜力变得复杂。通过分析以前的计划和当前的情况,我们发现采用患者健康记录系统可以增强患者的能力,并允许在国家层面更好地协调临床数据。我们建议建立区域 PHR“枢纽”,提供一个通用接口,在区域层面集成数字健康数据,并在国家层面进一步集成。我们建议这些 PHR 枢纽将减少连接的复杂性,降低治理挑战和互操作性问题,同时为高质量、可扩展和可持续的数字解决方案提供一个安全的平台,包括英国国民保健制度中的人工智能,为其他希望充分利用医疗记录价值的国家提供范例。