Liz Allan wrote:

> A PHR may be defined as "a computer-accessible, interoperable,
universally available, lifelong resource of pertinent health
information.  Maintained in a secure manner, the information originates
from a multitude of sources and is used by individuals and their
authorized clinical and wellness professionals to help guide and make
health decisions.  The record is different from and does not replace the
legal record of a provider."

This raises some interesting authenticity issues. If a PHR is providing
input into "the legal record of a provider", to what extent does that
provider then become responsible for the quality of the information
provided, and the consequent impact on the health decisions made? Also,
its unclear to me how the PHR is constructed - is it from the records of
covered entities through the individual, or direct from the covered
entities to the PHR service provider (in this case, Google) on behalf of
the individual? If either is the case, how are the records synchronized
over time, and who is responsible for ensuring that synchronization
occurs, so that the PHR accurately reflects the latest information from
its "multitude of sources"? What if a covered entity's records are
destroyed - does that occur also to the information in the PHR? Finally,
I wonder how, from a cost standpoint, this might be construed by covered
entities? Would they have a financial incentive to do what they can to
transfer record keeping responsibility to a non-covered PHR, thereby
lessening their records keeping cost burdens (which one would assume are
more onerous because of their status as covered entities)?

Well, I'm glad I was able to clear all that up. Any more questions?

Dwight Wallis, CRM
Records Administrator
Multnomah County Fleet, Records, Electronics, Distribution and Stores
(FREDS)
1620 S.E. 190th Avenue
Portland, OR 97233
Phone: (503)988-3741
Fax: (503)988-3754
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