The importance of personal health records (PHRs) and other technologies that can help patients and physicians improve health care was underscored today by the American College of Physicians (ACP). 

  ACP's statement came in reaction to an announcement made by a group of large employers.  Yesterday, the initial group of employers -- Wal-Mart, BP America, Intel, Pitney Bowes, and Applied Materials -- unveiled Dossia, a system the employers say will enable individuals to control their own medical data from multiple sources and to create and utilize their personal, private and portable electronic health records.

  Representing primary care medicine through a membership of more than 120,000 members, ACP is the nation's largest medical specialty society.  ACP emphasized that employers' efforts will only succeed if they are integrated into clinical practice at the point of care as part of an ongoing relationship between the patient and his/her physician.

  "ACP is leading the way with other professional societies -- including the American Academy of Family Physicians (AAFP) -- by working on a collaborative effort with employers to produce a patient-centered medical home (PC-MH) that will bring patient health records, electronic medical records and other technologies into the office to support an ongoing patient-physician relationship," said Lynne Kirk, MD, FACP, president of ACP.  "The effort has enormous potential to transform clinical practice through collaboration among patients, employers, vendors and physicians."   ACP is in discussions with payers, employers, and others to test elements of the PC-MH as well as a payment structure that recognizes and supports the benefits of care provided in a PC-MH. These demonstrat! ion projects will pay particular attention to the potential issues for small practices, which represent the majority of ACP's practicing members.

  The PC-MH model calls for a voluntary recognition process to identify practices that have qualified as medical homes.  Patient-centered medical homes provide a personal physician for each patient. The physician facilitates and coordinates high-quality care across the health-care system in partnership with patients (and their families when appropriate). Practices adopt a whole person orientation, commit to enhancing the quality and safety of care delivered, and report on nationally accepted quality measures of quality.  Health information technology, such as electronic health records, registries, and personal health records are used to promote the type of access to information and clinical decision support tools that are needed for the model to succeed. 

  Earlier in 2006, (ACP adopted a policy (PDF)) that describes key elements of personal health records (PHRs), including specific desired features: -- Individuals should have the option of providing different levels of access to PHRs for specific users of their PHR. -- Individuals should receive easily understood information about all the ways that their health data may be used or shared. -- PHR data should be collected in a structured format that uses standardized medical terminology described in laymen's terms. Collection in this manner will facilitate authorized export of data to electronic health records and electronic medical records. -- Terminology in PHRs should be appropriate for the typical patients' comprehension and health literacy   -- PHRs should create robust audit trails regarding access to, or modification of, data in the PHRs.     ACP looks forward to learning more about Dossia and evaluating opportunities for collaboration to develop a product that will enable individuals to control their own medical data from multiple sources and to create and utilize their personal, private and portable electronic health records as a component of redesigning the health care system.   The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States.  ACP members include 120,000 internal medicine physicians (internists), related subspecialists, and medical students.  Internists specialize in the prevention, detection and treatment of illness in adults. acponline