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H H S Department of Health and Human Services
U.S. Department of Health and Human Services
Health Information Technology and Quality
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What are the key challenges to PHR adoption?

While PHRs offer many potential benefits to both consumers and providers, there are certain barriers to PHR adoption. For instance, providers might have doubts about the utility of PHRs and whether the costs associated with establishing a PHR justify the possible benefits. This might be a particular concern considering the possibility of high start-up costs and the current lack of reimbursement and financial incentives to adopt PHRs. Proper research and education on this subject can help providers come to a financially sound solution.

Providers also have expressed concerns that the creation of new communication opportunities with patients will bring about an increase in workload. Some practitioners fear having to search through the large amounts of data that might be included in patients' PHRs in order to gather useful information. Additionally, there are questions about the accuracy of the data provided by patients in the PHR and whether doctors should use this information as a basis for medical decisions. 

Providers also see the possibility of legal and liability risks arising from the adoption of PHRs because the legal and medical responsibilities related to use of this technology have yet to be fully defined. For example, there is the concern among some practitioners that negligence charges might arise in cases where physicians make faulty care decisions based on inaccurate PHR information entered by the patient. Other legal risks exist in the areas of privacy and security.

Consumers also have a great deal of impact on PHR adoption. Institutions considering adopting PHRs are unlikely to do so if they do not perceive adequate consumer demand for the product. However, many consumers are simply uninformed about their rights to their health information and may have an unclear idea of what a PHR can offer. There continues to be a need for increased public education to increase awareness of the value of PHRs.

Another challenge for consumer adoption of PHRs involves the need for manual data entry. Implementing PHRs that are capable of integrating information from the patients' EHR is likely to have a positive impact on consumers' perception of the utility of PHRs. Similarly, PHRs that are consumer-friendly and easily accessible by individuals with different levels of health literacy will increase consumer interest in PHRs.

Privacy, security and confidentiality are also key areas of concern for consumers. Uncertainties surrounding the HIPAA privacy rule and its application to PHRs might make consumers less receptive towards adopting a PHR system. Suspicion with regard to whether their health information will be kept private, confusion about their rights and policy uncertainties have all been cited as issues that must be resolved before consumers can embrace PHRs. In order to address these concerns, various organizations are promoting standards frameworks for privacy and security.

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