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continued from page 7 mon question about what medications a patient uses. "A new patient walks in to see the cataract surgeon and is asked what medications she is on. The patient typically might say 'I don't know' or hand over a bag with every medication bottle she has. You're dealing with an older population that tends to have more medication," Ms. Wolter said. "With a PHR, [patients] can say 'I take X, Y, and Z,' or simply show the doctor a list." A PHR program may even remind patients to include over-thecounter medications or herbal supplements on their medication list— two areas that patients frequently exclude. Another scenario might be people who have to get a medication list to their parent's eye doctor. With an electronic PHR, people can easily send the medication list to that doctor, Dr. Bielory said. Then the doctor can quickly find out if the patient uses drugs that would trigger further cautions or assessments related to eyecare. A patient with a PHR can help ease communication among specialists involved with eyecare, such as allergists, rheumatologists, and immunologists, Dr. Bielory said. Patients can share reports or medication prescription copies among the specialists required for their care, instead of practice staff spending time on the phone to track down crucial information. "People in healthcare want to communicate, but we don't. So who else can we turn to but the patient?" Ms. Wolter said. The benefits for patients Of course, a PHR is naturally more geared to benefit patients, even 8 though physicians indirectly benefit from them, said Ms. Wolter. One patient benefit is that PHRs force patients to take an active role in their healthcare. "If they are an active member of the team, it will help them make the healthcare decisions they need," she said. Ms. Wolter told the story of going to a doctor's visit with her PHR in a three-ring binder that she carried with her. As the doctor started to take notes about her problem, she started to take notes about what he said to her. The doctor asked what she was doing—and was amused but impressed by her diligence. Having a PHR helps patients to prepare for productive doctors visits, Ms. Wolter added. "Doctors are short on time and as patients, we have to be succinct to get as much out of the visit as possible. With a PHR, patients walk out of the office smiling because they got what they needed and had a great communication with their doctor," she said. Results from a focus group of glaucoma patients on what they think of PHRs was published in the August issue of Ophthalmic & Physiological Optics.1 The 71 participants expressed enthusiasm for PHRs, with some favoring electronic records while others preferred a lowtech format. The authors concluded that a patient-centered PHR may serve as both a health record and a self-educational tool for better glaucoma care. PHR challenges Although the idea of patients proactively collecting their health information in an organized fashion sounds great in theory, it does come with some challenges, Ms. Wolter said. Ophthalmology Business • December 2013 First, patients have to know what to ask for. They may not know they can ask for copies of lab work or history and physical reports and similar data, she said. Health literacy plays a role in the data collection as well, both in terms of patients knowing they can ask for their personal health information and for understanding the results, she said. The internet can get in the way of patients accurately understanding medical information. These challenges create extra work for physicians, who may need to spend more time coaching patients on health information. "When patients are sitting face-toface with their doctors, the doctors become the front-line educators and may need to say what resources and tools they would like to see patients use," she said. Going forward, PHRs have great potential to expand. More electronic PHRs will be developed, and insurance companies or large hospital systems may find ways to link their EHRs with PHRs, said Ms. Wolter. PHRs are even becoming available for pets, both Dr. Bielory and Ms. Wolter said. OB Reference 1. Somner JE, Sii F, Bourne R, Cross V, Shah P. What do patients with glaucoma think about personal health records? Ophthalmic Physiol Opt. 2013 Aug. 6. [Epub ahead of print] Editors' note: Dr. Bielory is the creator of Raphael PMR. Ms. Wolter has no financial interests related to this article. Contact information Bielory: drlbielory@STARxTech.com, bielory@Rutgers.edu Wolter: 314-977-8720, wolterjl@slu.edu