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As resources become available for patients to take control over the medical information in their health records, the dynamics of how clinical research is done will likely shift dramatically, Children's Hospital Boston researchers state in a Sounding Board article published in the April 17 issue of The New England Journal of Medicine. While the move to personally controlled health records (PCHRs) will provide patients and doctors with easier access to records during the clinical care process, it will also profoundly affect the biomedical research enterprise, the authors predict.
"Giving patients access and control over their medical records will unlock a whole new world where researchers will suddenly be able to recruit hundreds, thousands, possibly millions of patients from all over the world, and have access to all new data sets and populations," said Isaac Kohane, MD, PhD, of the Children's Hospital Informatics Program (CHIP) and co-author of the article. "Imagine the possibilities this will bring and the impact it will have on bringing research to the bedside."
It is expected that at some point in the future, personal or patient-controlled health records (PCHRs) will be universally available and used. With PCHRs, patients have web-based access to almost all the information in their medical records (currently only under the control of hospital personnel) and will be able to authorize anyone of their choosing to have access to that information, including lab tests, diagnosis, medications and clinical notes.
"While this is exciting indeed," says Kenneth Mandl, MD, MPH, also of CHIP and co-author of the article, "without forethought and regulation, the tremendous benefit of PCHRs - for research and clinically - could easily be overshadowed by problems that could arise from the unethical and uncontrolled use of a patient's valuable medical information."
Traditionally, academic medical centers, health maintenance organizations and health networks - all covered entities under the Health Insurance Portability and Accountability Act (HIPAA) - held institutional control over their patients' health records. With the emergence of PCHRs, companies new to health care have become more involved and may ultimately house and manage a patient's health care information, no longer putting hospitals and health care institutions in the control seat and exposing patients' data to entities not covered by HIPAA.
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