Personal Health Record Applications Research Articles

Latent iron deficiency in Indian women and children: A descriptive analysis

Iron deficiency is a global health concern, particularly in developing countries like India. While overt iron deficiency anemia (IDA) is well-documented, Latent Iron Deficiency (LID), a precursor to IDA, remains under-recognized. This study aims to elucidate the proportion of the Indian population with latent iron deficiency and underscore the importance of early detection of this condition.: 344624 anonymized medical records available through a personal health record (PHR) application developed by Eka Care, a health information technology company, were analysed. The ethical handling of data ensured that no personally identifiable information (PII) was accessible or utilized during the research process.: Children aged 5-15 years had a LID prevalence of 32.7% (95% CI:27.4%,37.9%) while women aged 15-49 years had a prevalence of 31.5% (95% CI:30.3%,32.6%). 9% (95% CI: 8.5%,9.5%) of men in the same age group had LID.This study revealed a significant burden of latent iron deficiency among Indian women and children. By implementing targeted screening and intervention strategies, one can improve health outcomes and break the cycle of iron deficiency in these vulnerable populations.LID poses a serious risk for developing iron deficiency anemia (IDA) during and after pregnancy. Iron deficiency can adversely affect maternal and fetal health.This burden of LID highlights the critical need for routine screening and early intervention to prevent these adverse outcomes.

Quality of Care in Hospitals and the Use of Mobile-Based Personal Health Record Applications: An Exploratory Study Using National Hospital Evaluation Data.

The use of mobile-based personal health record (m-PHR) applications at the hospital level has been minimally studied. This study aimed to investigate the relationship between m-PHR use and quality of care. A cross-sectional study design was employed, analyzing data from 99 hospitals. Two data sources were utilized: a previous m-PHR investigation conducted from 26 May to 30 June 2022 and a hospital evaluation dataset on quality of care. The use of m-PHR applications was measured by the number of m-PHR application downloads. Three independent variables were assessed: quality of care in the use of antibiotic drugs, injection drugs, and polypharmacy with ≥6 drugs. A generalized linear model was used for the analysis. The hospitals providing high-quality care, as evaluated based on the rate of antibiotic prescription (relative risk [RR], 3.328; 95% confidence interval [CI], 1.840 to 6.020; p < 0.001) and polypharmacy (RR, 2.092; 95% CI, 1.027 to 4.261; p = 0.042), showed an increased number of m-PHR downloads. Among the hospital covariates, public foundation status and being part of multi-hospital systems were associated with the number of m-PHR downloads (p < 0.05). This exploratory study found a positive relationship between quality of care and m-PHR use. Hospitals providing high-quality care may also excel in various activities, including m-PHR application use.

A randomized controlled trial of an app-based intervention on physical activity and glycemic control in people with type 2 diabetes.

We investigated the effects of a physical activity encouragement intervention based on a smartphone personal health record (PHR) application (app) on step count increases, glycemic control, and body weight in patients with type 2 diabetes (T2D). In this 12-week,single-center, randomized controlled, 12-week extension study, patients with T2D who were overweight or obese were randomized using ratio 1:2 to a group using a smartphone PHR app (control group) or group using the app and received individualized motivational text messages (intervention group) for 12weeks. During the extension period, the sending of the encouraging text messages to the intervention group was discontinued. The primary outcome was a change in daily step count after 12weeks and analyzed by independent t-test. The secondary outcomes included HbA1c, fasting glucose, and body weight analyzed by paired or independent t-test. Of 200 participants, 62 (93.9%) and 118 (88.1%) in the control and intervention group, respectively, completed the 12-week main study. The change in daily step count from baseline to week 12 was not significantly different between the two groups (P = 0.365). Among participants with baseline step counts < 7,500 steps per day, the change in the mean daily step count at week 12 in the intervention group (1,319 ± 3,020) was significantly larger than that in control group (-139 ± 2,309) (P = 0.009). At week 12, HbA1c in the intervention group (6.7 ± 0.5%) was significantly lower than that in control group (6.9 ± 0.6%, P = 0.041) and at week 24, changes in HbA1c from baseline were significant in both groups but, comparable between groups. Decrease in HbA1c from baseline to week 12 of intervention group was greater in participants with baseline HbA1c ≥ 7.5% (-0.81 ± 0.84%) compared with those with baseline HbA1c < 7.5% (-0.22 ± 0.39%) (P for interaction = 0.014). A significant reduction in body weight from baseline to week 24 was observed in both groups without significant between-group differences (P = 0.370). App-based individualized motivational intervention for physical activity did not increase daily step count from baseline to week 12, and the changes in HbA1c levels from baseline to week 12 were comparable. ClinicalTrials.gov (NCT03407222).

Subjective Cognitive Load Evaluation of a Mobile Personal Health Record Application.

Mobile Personal Health Records (mPHRs), which make it possible to track and manage users' health information, can be an important aid in improving people's health. Despite its potential benefits, poor usability of systems can hinder the adoption and use of mPHRs. This study aims to evaluate the usability of a mobile health application in terms of perceived cognitive workload and performance. The cognitive workload experienced by 30 volunteers (15 experienced and 15 inexperienced), was measured while performing the given tasks with the NASA-Task Load Index (NASA-RTLX) scale, and the duration of the fulfillment of the tasks by eye tracking device. While there was no significant difference between the two user groups in the completion time of the tasks, a significant difference was found in the perceived cognitive load. "Making an appointment", which could take much longer to complete than other tasks, resulted in the highest cognitive load for all users. Further usability research using think-aloud protocols and user interviews could provide insights into design improvements for reducing cognitive load and enhancing performance.

"Seeing the light in the shade of it": primary caregiver and youth perspectives on using an inpatient portal for pain care during hospitalization.

Studies from multiple countries report that most hospitalized children, especially the youngest and sickest, experience pain that is often severe yet inadequately treated. Evidence suggests this can lead to immediate and lifelong consequences affecting children, families, and communities. Partnership and shared decision-making by children, families, and clinicians is the ideal pediatric healthcare model and can improve care quality and safety, including pain care. A growing evidence base demonstrates that inpatient portals (electronic personal health record applications linked to hospital electronic medical or health records) can improve child and family engagement, outcomes, and satisfaction during hospitalization. This study examined the perspectives of caregivers of hospitalized children and of hospitalized youth about using an inpatient portal to support their engagement in pain care while in hospital. A qualitative descriptive study design was used and 20 participants (15 caregivers and 5 youth) with various painful conditions in one pediatric hospital participated in semistructured interviews. The authors applied a reflexive content analysis to the data and developed 3 broad categories: (1) connecting and sharing knowledge about pain, (2) user-centred designs, and (3) preserving roles. These findings outlined caregiver and youth recommendations for portal configurations that deeply engage and empower children and families in pain care through multidirectional knowledge sharing, supporting caregiver and clinicians' roles without burdening, or replacing human interaction implicit in family-centered pain care. Further research should measure the impact of portals on pain-related outcomes and explore the perspectives of clinicians.

Factors associated with the download and use of mobile personal health record applications in Korean hospitals.

The use of mobile personal health records (m-PHR) has been little studied at the organizational level. This study was to investigate the relationships of various hospital-related factors with m-PHR use in Korean hospitals. Downloads of m-PHR applications for 101 hospitals were examined from May 26 to 30 June 2022. The dependent variable was the number of m-PHR downloads, and the major independent variables included six technological, organizational, and environmental factors. As technological factors, the number of computed tomography and magnetic resonance imagery devices were significantly associated with downloads (RR = 1.119, CI = 1.022-1.226, p = 0.016; and RR = 1.155; 95% CI = 1.024-1.302, p = 0.019, respectively). At the organizational level, the number of physicians, adjusting for the number of beds, and the number of medical information management staff showed significant associations (RR = 1.059, CI = 1.019-1.100, p = 0.004; and RR = 1.026, CI = 1.002-1.050, p = 0.033, respectively). From an environmental standpoint, downloads were positively associated with the proportion of the local population of working age (20-59years) (RR = 1.102, CI 1.022-1.189, p = 0.012). Healthcare policymakers should pay close attention to these factors to advocate for the widespread use of m-PHR applications.

Effects of high-fiber food product consumption and personal health record use on body mass index and bowel movement

A health program including consumption of high-fiber ZENB Noodles (ZN) and ZENB Sticks (ZS), combined with the use of a personal health record (PHR) was employed; effects on body mass index (BMI) and bowel movement were evaluated. Fifty-nine healthy adults with overweight (mean baseline BMI, 27.0 kg/m2) participated and consumed ZN and ZS once daily, five days/week for 12 weeks and tracked their dietary intake, body weight, and blood pressure using a mobile PHR application (Welby My Carte). Mean BMI decreased significantly to 26.8 kg/m2 at 8 weeks (p = 0.031). The mean number of weekly bowel movements per participant increased significantly from 6.95 at baseline to 8.78, 8.34, and 8.58 at 4, 8, and 12 weeks, respectively (all p < 0.001). Thus, high-fiber food product consumption and PHR use decreased BMI and improved bowel movement among healthy adults with overweight. This study was registered in the UMIN Clinical Trials Registry (UMIN trial ID:UMIN000040105).

Application of Personal Health Record in Enhancing the Quality of Life in Patients With Breast Cancer Who Received Adjuvant Hormonal Therapy.

Recently, personal health records (PHR) have become a communication tool between patients and medical professionals. PHR applications (PHR app) can be installed on smartphones to record patient-reported outcomes (PROs). This study prospectively examined whether patients with breast cancer could record PROs, including subjective and objective symptoms, on PHR app. Patients who received adjuvant hormonal therapy were enrolled. The patients were asked to collect PROs related to physical conditions, symptoms, and medications on their PHR app from the beginning of therapy for one month. Quality of life (QoL) was evaluated before treatment initiation and one month after. Patients completed a questionnaire of their opinions concerning the PHR app after use. Fourteen patients were enrolled between October and December 2020. All patients could use the PHR app during the study period without any negative effects on QoL. Eleven (79%) patients fully recorded their PROs on the app. Typical side effects induced by hormonal therapy to reduce the QoL were observed (hot flash in two patients, 14.3%). The questionnaire revealed that approximately 70% wanted to use the PHR app in the future to communicate with medical staff and to report adverse events. Specifically, 90% of patients who experienced difficulty communicating with medical staff wanted to use the PHR app. Some patients wanted to utilize the PHR app to set reminders to take medications. The PHR app can be applied as a communication tool between patients taking adjuvant hormonal therapy and medical professionals.

A Blockchain-Applied Personal Health Record Application: Development and User Experience

This study aims to introduce a novel blockchain-applied personal health records (PHR) application and validate its user experience. The system transmits the part corresponding to the patient’s personal information off-chain and prevents data forgery and falsification by storing encrypted data on-chain. Patients may easily trace the opt-in and opt-out history of their consent data and dynamically store the consent system for data exchange on the blockchain. A mixed-method study using a questionnaire, in-depth interviews, and usability evaluation were conducted for 30 participants. The system usability score was 74.0, indicating the high usability of the application. Those who were familiar with blockchain showed confidence in the application, but those unfamiliar wanted their data to be safe using another way. Most of the participants were interested in exchanging and using their medical data and considered security important but those unfamiliar wanted their data to be safe using another way. We found that participants were concerned about data security and considered a blockchain-based PHR as a novel way to store and exchange their medical information securely. Blockchain is not a visible technology. However, a blockchain-applied PHR must be able to win user trust through visualizations, certificates, and system descriptions.

Designing and evaluating a mobile personal health record application for kidney transplant patients

BackgroundDue to their close relationships with diabetes mellitus (DM) and hypertension (HTN), kidney transplant patients (KTPs) are constantly facing numerous chronic conditions and self-care challenges. In this respect, a personal health record (PHR) is one of the most important self-care tools, which provides access to self-care services as well as chronic disease management (CDM) through monitoring and learning. MethodsThis applied-developmental research was completed in three phases. The first phase was associated with the minimum data set (MDS), including (A) finding relevant resources from the databases of PubMed, Google Scholar, Web of Science, Scopus, and Science Direct, as well as gray literature, (B) extracting information related to KTP health record (KTPHR), (C) assessing the quality of studies via a rating checklist, and (D) designing an initial KTPHR model and its validation by the Delphi technique based on expert opinions. The second phase also consisted of the development of a KTPHR app for Android. In the third phase, the KTPHR usability was evaluated by think-aloud and heuristics techniques. ResultsThe study results comprised of [1] developing the MDS for KTPs with reference to a systematic method and a scoring system (namely, 10 classes and 80 data set elements), and [2] designing and building the KTPHR app with features such as health records, data dashboard, test results, medications, appointments/visits, and training to prolong the life of a transplanted kidney [3], reflecting on usability evaluation outcomes to demonstrate that qualitative evaluation was more reliable for identifying problems than quantitative heuristics. In addition, utilizing the rating checklist revealed that the principles of "flexibility and efficiency of use" had a higher severity than other cases, and the principle of "help users recognize, diagnose, and recover from errors" had a lower severity by itself. ConclusionThe final KTPHR model was designed through reviewing the related literature, and validation by clinical and basic science specialists to improve self-care behaviors in KTPs, and consequently facilitate and accelerate decision-making by clinicians. Since the final KTPHR model met the main criteria for evaluation purposes, including content validity and usability, it can be used with more confidence and reliability.

PEERNaija: A Gamified mHealth Behavioral Intervention to Improve Adherence to Antiretroviral Treatment Among Adolescents and Young Adults in Nigeria.

Background:HIV is the leading cause of death for youth in Sub-Saharan Africa (SSA). The rapid proliferation of smart phones in SSA provides an opportunity to leverage novel approaches to promote adherence to life-saving antiretroviral therapy (ART) for adolescents and young adults living with HIV (AYA-HIV) that go beyond simple medication reminders.Methods:Guided by the Integrate, Design, Assess and Share (IDEAS) framework, our multidisciplinary team developed a peer-based mHealth ART adherence intervention—PEERNaija. Grounded in Social Cognitive Theory, and principles of contingency management and supportive accountability, PEERNaija delivers a multi-faceted behavioral intervention within a smartphone application to address important obstacles to adherence.Results:PEERNaija was developed as a gamified Android-based mHealth application to support the behavioral change goal of improving ART adherence among AYA-HIV within Nigeria, a low- and middle- income country (LMIC). Identified via foundational interviews with the target population and review of the literature, key individual (forgetfulness and poor executive functioning), environmental (poor social support) and structural (indirect cost of clinic-based interventions) barriers to ART adherence for AYA-HIV informed application features. Further informed by established behavioral theories and principles, the intervention aimed to improve self-efficacy and self-regulation of AYA-HIV, leverage peer relationships among AYA to incentivize medication adherence (via contingency management, social accountability), provide peer social support through an app-based chat group, and allow for outreach of the provider team through the incorporation of a provider application. Gamification mechanics incorporated within PEERNaija include: points, progress bar, leaderboard with levels, achievements, badges, avatars and targeted behavior change messages. PEERNaija was designed as a tethered mobile personal health record application, sharing data to the widely deployed OpenMRS electronic health record application. It also uses the secure opensource Nakama gamification platform, in line with Principles of Digital Development that emphasize use of opensource systems within LMICs.Conclusions:Theory-based gamified mHealth applications that incorporate social incentives have the potential to improve adherence to AYA-HIV. Ongoing evaluations of PEERNaija will provide important data for the potential role for a gamified, smartphones application to deliver multifaceted adherence interventions for vulnerable AYA-HIV in SSA.

Factors Affecting the Behavioral Intention to Use Standalone Electronic Personal Health Record Applications by Adults in Egypt

Standalone electronic personal health record can be a useful tool that enables individuals to store, arrange and share their health information easily and they can build a history of their health timeline which is crucial for raising healthcare quality and better self-management, the adoption rate of these applications has been identified in several countries to be low and slowly progressing.Although there are some applications of standalone ePHR available in the market for usage free of charge but it’s almost not adopted at all, this study will investigate some of the factors that might affect the adoption of ePHR technology by adults in Egypt and provide business professionals a better picture for what can motivate or hinder the adoption process to achieve better adoption rates and eliminate the barriers.In order to ensure a comprehensive contextual analysis, researchers analyzed the research in hand with the perspective of the proposed contextual framework, the Nine Elements Framework/Model (Elsafty, 2018) that analyzes social studies research in general, and business/management reseaerches as well.Using the nine elements framework, the authors used it to discover the underlying factors that are causing the problems faced by the research in hand, and resulted in the coming contextual analysis defining the research scope and focus, which in the case of this paper is on Perceived usefulness and perceived ease of use were adapted from TAM that was initially developed by Fred Davis (1989) and they proved to have a high predictive power of behavioral intention in CHI context, The extensions of TAM including UTAUT &amp; UTAUT2 seems to be irrelevant to this research context since UTAUT is more oriented towards the organizational context (Venkatesh et al., 2012) and UTAUT2 added factors, Price value seems to be irrelevant in this research context as we are already studying platforms that are provided free of charge, Hedonic motivation maybe irrelevant to this context as healthcare related service is mostly associated with seriousness and urgency, also testing unimplemented platforms that are not yet adopted makes from the habit unrealistic experience that may be inaccurate to measure.Since other several researches recommended extending these factors with other additional factors to make it more relevant to the healthcare consumer context (Kim &amp; Park, 2012), these factors may include health-related factors, technology-related factors and personal-related factors. Findings in this research revealed that adoption rate in Egypt is still very low and high demand for this service which makes this research is significant as it’s trying to find out the reasons behind this gap, perceived usefulness, perceived ease of use, (privacy and security), eHealth literacy, personalization and awareness had a significant impact on behavioral intention to use standalone ePHR applications. Personalization was found to have the strongest effect on behavioral intention followed by perceived usefulness. Health status was found to have an insignificant effect on behavioral intention which indicates the interest of people with different health statuses in standalone ePHR.

Analysis of Platforms and Functions of Mobile-Based Personal Health Record Systems.

ObjectivesLittle is known about the platforms and functionalities of mobile-based personal health record (PHR) applications. The objective of this study was to investigate these two features of PHR systems.MethodsThe unit of analysis was general hospitals with more than 100 beds. This study was based on a PHR survey conducted from May 1 to June 30, 2020 and the National Health Insurance administrative data as of March 31, 2020. The study considered the platform, Android and iPhone operation system (iOS), and types of functionalities of PHR systems. Among the 316 target hospitals, 103 hospitals had adopted PHR systems. A logistic regression analysis was used.ResultsThis study found that 103 hospitals had adopted mobile-based PHR systems for their patients. Sixty-four hospitals (62.1%) were adopting both Android and iOS, but 36 (35.0%) and 3 (2.9%) hospitals were adopting Android only or iOS only, respectively. The PHR systems of hospitals adopting both platforms were more likely to have functions for viewing prescriptions, clinical diagnostic test results, and upcoming appointment status compared to those adopting a single platform (p < 0.001). The number of beds (odds ratio [OR] = 1.004; confidence interval [CI], 1.001–1.007; p = 0.0029) and the number of computed tomography systems (CTs) per 100 beds (OR = 6.350; CI, 1.006–40.084; p = 0.0493) were significantly associated with the adoption of both platforms.ConclusionsMore than 60% of hospitals had adopted both Android and iOS platforms for their patients in Korea. Hospitals adopting both platforms had additional functionalities and significant association with the number of beds and CTs.

Development of a Mobile Personal Health Record Application Designed for Emergency Care in Korea; Integrated Information from Multicenter Electronic Medical Records

Collecting patient’s medical data is essential for emergency care. Although hospital-tethered personal health records (PHRs) can provide accurate data, they are not available as electronic information when the hospital does not develop and supply PHRs. The objective of this research was to evaluate whether a mobile app can assemble health data from different hospitals and enable interoperability. Moreover, we identified numerous barriers to overcome for putting health data into one place. The new mobile PHR (mPHR) application was developed and evaluated according to the four phases of the system development life cycle: defining input data and functions, developing a prototype, developing a mobile application, and implementation testing. We successfully introduced the FirstER (First for Emergency Room) platform on 23 September 2019. Additionally, validation in three tertiary hospitals has been carried out since the launch date. From 14 October to 29 November 2019, 1051 cases registered with the FirstER, and the total download count was 15,951 records. We developed and successfully implemented the mPHR service, which can be used as a health information exchange tool in emergency care, by integrating medical records from three different tertiary hospitals. By recognizing the significance and limitations of this service, it is necessary to study the development and implementation of mPHR services that are more suitable for emergency care.

A systematic approach to equity assessment for digital health interventions: case example of mobile personal health records

Despite the increasing number of digital health interventions in low- and middle-income countries and other low-resource settings, little attention has been paid to systematically evaluating impacts of these interventions on health equity. In this article, we present a systematic approach for assessing equity impacts of digital health interventions modeled after the Health Equity Impact Assessment of the Ontario Ministry of Health and Long-Term Care. The assessment approach has 4 steps that address (1) scope, (2) potential equity impacts, (3) mitigation, (4) monitoring, and (5) dissemination strategies. The approach examines impacts on vulnerable and marginalized populations and considers various social determinants of health. Equity principles outlined by Whitehead and Dahlgren are used to ensure systematic considerations of all potential equity impacts. The digital health evaluation approach that is presented is applied to a case example of mobile personal health record application in Kenya.

Recommended configuration for personal health records by standardized data item sets for diabetes mellitus and associated chronic diseases: A report from Collaborative Initiative by six Japanese Associations.

It is expected that a large amount of data related to diabetes and other chronic diseases will be generated. However, databases constructed without standardized data item sets can be limited in their usefulness. To address this, the Collaborative Committee of Clinical Informatization in Diabetes Mellitus was established in 2011 by the Japan Diabetes Society and Japan Association for Medical Informatics. The committee has developed core item sets and self‐management item sets for diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease in collaboration with the Japanese Society of Hypertension, Japan Atherosclerosis Society, Japanese Society of Nephrology, and Japanese Society of Laboratory Medicine, as well as a mapping table that aligns the self‐management item sets with the Japanese standardized codes for laboratory testing. The committee also determined detailed specifications for implementing the four self‐management item sets in personal health record (PHR) applications to facilitate risk stratification, the generation of alerts using information and communications technology systems, the avoidance of data input errors, and the generation of reminders to input the self‐management item set data. The approach developed by the committee may be useful for combining databases for various purposes (such as for clinical studies, patient education, and electronic medical record systems) and for facilitating collaboration between PHR administrators.

The new European interoperability framework as a facilitator of digital transformation for citizen empowerment.

Healthcare is a highly regulated domain. Seamless, online access to integrated electronic health records for citizens is still far from becoming a reality. The implementation of personally managed health data systems still needs to overcome several interoperability, usability, ethics, security, and regulatory issues to deliver the envisioned benefits. This paper offers a policy viewpoint on how the new European Interoperability Framework (EIF) may benefit the implementation of eHealth systems for the management of personal health information for citizens. Interoperability facilitates sharing of health and illness experiences, coordinated care and research for citizen empowerment and improved health outcomes. The adoption of principles relevant to core interoperability and generic user needs and expectations, as described in the new EIF, in line with European and national regulations are quite essential for the development of safe and secure patient access services to support mobility. An interoperability framework facilitates the creation of the appropriate context in which personal health record applications can be designed and implemented in support of disease specific solutions, such as chronic non-malignant pain, diabetes and cancer. It is evident that no solution will fit all circumstances. However, the new EIF, when adapted for personally managed health data, provides a useful and relevant framework to facilitate implementation and adoption of personal health record systems within a coordinated care environment. Practical implications of this work relate to the need of multi-disciplinary cooperation and European level compatibility and sustainability of the underlying infrastructures required to support reliable and secure access to and sharing of medical data, as well as the readiness to address continuously evolving functional and non-functional requirements for regional, national, and cross-border settings.

Information technologies that facilitate care coordination: provider and patient perspectives.

Health information technology is a core infrastructure for the chronic care model, integrated care, and other organized care delivery models. From the provider perspective, health information exchange (HIE) helps aggregate and share information about a patient or population from several sources. HIE technologies include direct messages, transfer of care, and event notification services. From the patient perspective, personal health records, secure messaging, text messages, and other mHealth applications may coordinate patients and providers. Patient-reported outcomes and social media technologies enable patients to share health information with many stakeholders, including providers, caregivers, and other patients. An information architecture that integrates personal health record and mHealth applications, with HIEs that combine the electronic health records of multiple healthcare systems will create a rich, dynamic ecosystem for patient collaboration.

Effects of Personal Health Record on Patient Healthcare Outcomes

Electronic transmission of data is on the rise, due to the Affordable Care Act and provisions to make healthcare information more accessible, complete, and transparent. The Personal Health Record (PHR) application is a tool used to provide assistance to the goal of patient-centered and patient-centric care. Its purpose is to encourage consumers to become more participatory and informed in their healthcare treatment and healthcare needs. Since its inception, it has been questionable as to whether consumers and providers are seeing any improvements in the services provided or the care rendered. Since, the development and implementation of PHR applications, there has been some resistance from consumers for concerns of privacy and security of their information. This paper will discuss the uses of the PHR among consumers and providers and whether its use has impacted accessibility, services, and overall healthcare treatment/outcomes.

Between Personal and Common: the Design of Hybrid Information Spaces

This paper addresses the design of hybrid information spaces supporting patients and healthcare providers to have information in common and also, patients to manage privately personal health information. We studied efforts to develop such information spaces by following the design of two Personal Health Record applications and focusing particularly on design tensions that relate to their hybrid role. We identified and grouped tensions along three key themes: control allocation, content origination and user environment localization. For the resolution of tensions, functionality-related decisions were taken by professional design teams during the early design phases. These included the introduction of functionality that enables end-users to create regions with custom characteristics and dynamically adjust the regional boundaries. Delegating to end-users some of the regionalization work entailed in the design of such hybrid spaces points to a design strategy of providing generic enabling environments instead of configuring solutions “a priori” by designers that are external to use settings. Prior research on Personal Health Records mostly emphasizes the challenges of bridging patient and provider perspectives, in our research we shift attention to enabling hybridity and to the roles of designers and end-users for regionalization.