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BACKGROUND

PHRs have emerged as a new option for patients to become active participants in the federal push towards widespread digitized healthcare in the U.S. National Committee on Vital and Health Statistics (NCVHS, 2001) has identified the individual (personal health) as a key stakeholder in a technological National Health Information infrastructure, along with communities (population health) and healthcare providers. PHRs are seen as a critical component of an effective healthcare system, as they promote the patient-centeredness aspect of the six aims for improving healthcare called for by the Institute of Medicine, including safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity (IOM, 1999, 2001).

The drive toward PHRs gained momentum in 2004 when the U.S. President signed Executive Order 13335, calling for "the development and nationwide implementation of an interoperable health information technology infrastructure to improve efficiency, reduce medical errors, raise the quality of care, and provide better information for patients, physicians, and other healthcare providers" (Brailer, 2005). This momentum is continuing in the U.S. with a steady flow of bills promoting a National Health Information Network (NHIN), overall health information technology adoption (S.1408, 2007; S.1455, 2007; S.1693, 2007), physician grants for EMR purchases (HR 2377, 2007), and physician reimbursement for each PHR that is provided to a patient.


  

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