January 27, 2011 —
Ethics Programs faculty led by Reid Cushman recently published an article on ethical, legal and social issues associated with personal health records (PHR) in a special issue of the Journal on Biomedical Informatics. The article Ethical, legal and social issues for personal health records and applications was authored by Ethics Program faculty Reid Cushman, UM School of Medicine; A. Michael Froomkin, UM School of Law, Anita Cava and Patricia Abril, Department of Business Law ; and Kenneth Goodman, UM School of Medicine.
Robert Wood Johnson Foundation’s Project HealthDesign included funding of an ethical, legal and social issues (ELSI) team, to serve in an advisory capacity to the nine design projects. In that capacity, the authors had the opportunity to analyze the personal health record (PHR) and personal health application (PHA) implementations for recurring themes. PHRs and PHAs invert the long-standing paradigm of health care institutions as the authoritative data-holders and data-processors in the system. With PHRs and PHAs, the individual is the center of his or her own health data universe, a position that brings new benefits but also entails new responsibilities for patients and other parties in the health information infrastructure. Implications for law, policy and practice follow from this shift. This article summarizes the issues raised by the first phase of Project HealthDesign projects, categorizing them into four topics: privacy and confidentiality, data security, decision support, and HIPAA and related legal-regulatory requirements. Discussion and resolution of these issues will be critical to successful PHR/PHA implementations in the years to come.
