"As a hub of information and information-management tools controlled by the patient, personal health records present a number of promises, perils, and challenges in the years ahead. In this report, six experts share their views on the future of PHRs, from the perspective of the technologist, informed patient, physician, employer, and public health professional.

Letter report on Personal Health Record (PHR) systems "describes initial findings from national hearings covering the many types of systems referred to as “Personal Health Records,” suggests areas for further exploration, and offers twenty recommendations..."

This 2005 edition supersedes the 2000 and 2003 editions of the report.

"The eight core capabilities that EHRs should possess are:

• Health information and data. Having immediate access to key information -- such as patients' diagnoses, allergies, lab test results, and medications -- would improve caregivers' ability to make sound clinical decisions in a timely manner.
• Result management. The ability for all providers participating in the care of a patient in multiple settings to quickly access new and past test results would increase patient safety and the effectiveness of care.
• Order management. The ability to enter and store orders for prescriptions, tests, and other services in a computer-based system should enhance legibility, reduce duplication, and improve the speed with which orders are executed.
• Decision support. Using reminders, prompts, and alerts, computerized decision-support systems would help improve compliance with best clinical practices, ensure regular screenings and other preventive practices, identify possible drug interactions, and facilitate diagnoses and treatments.
• Electronic communication and connectivity. Efficient, secure, and readily accessible communication among providers and patients would improve the continuity of care, increase the timeliness of diagnoses and treatments, and reduce the frequency of adverse events.
• Patient support. Tools that give patients access to their health records, provide interactive patient education, and help them carry out home-monitoring and self-testing can improve control of chronic conditions, such as diabetes.
• Administrative processes. Computerized administrative tools, such as scheduling systems, would greatly improve hospitals' and clinics' efficiency and provide more timely service to patients.
• Reporting. Electronic data storage that employs uniform data standards will enable health care organizations to respond more quickly to federal, state, and private reporting requirements, including those that support patient safety and disease surveillance."

[National-Academies.org]

" This document is a framework for an EHR for British Columbians. It also represents British Columbia's contribution to the pan-Canadian effort to develop an EHR.

Summary conclusions:

• "Health care professionals and organizations should adopt the computer-based patient record (CPR) as the standard for medical and all other records related to patient care.
• To accomplish Recommendation No.1, the public and private sectors should join in establishing a Computer-based Patient Record Institute (CPRI) to promote and facilitate development, implementation, and dissemination of the CPR.
• Both the public and private sectors should expand support for the CPR and CPR system implementation through research, development, and demonstration projects. Specifically, the committee recommends that Congress authorize and appropriate funds to implement the research and development agenda outlined herein. The committee further recommends that private foundations and vendors fund programs that support and facilitate this research and development agenda.
• The CPRI should promulgate uniform national standards for data and security to facilitate implementation of the CPR and its secondary databases.
• The CPRI should review federal and state laws and regulations for the purpose of proposing and promulgating model legislation and regulations to facilitate the implementation and dissemination of the CPR and its secondary databases and to streamline the CPR and CPR systems.
• The costs of CPR systems be should shared by those who benefit from the value of the CPR. Specifically, the full costs of implementing and operating CPRs and CPR systems should be factored into reimbursement levels or payment schedules of both public and private sector third-party payers. In addition, users of secondary databases should support the costs of creating such databases.
• Health care professional schools and organizations should enhance educational programs for students and practitioners in the use of computers, CPRs, and CPR systems for patient care, education, and research."

This early report gave the following varied view of the possible functions of an EMR, writing that it could "support users by providing accessibility to complete and accurate data, alerts, reminders, clinical decision support systems, links to medical knowledge and other aids."

The main recommendation of the report was that healthcare professionals and institutions should adopt the electronic medical record as the standard method for recording all data related to patient care.