• What Are Health Record Banks? ▲
  Health Records Banks (HRBs) or Personal Health Records (PHRs) are a single, unified, lifetime repository of all your health records.
• Why are they needed?▲
  Today, whenever you seek care, a record is left behind. Until now, there hasn't been a secure, unified location to store these records so that they can all be used to help guide your care.
• How do Health Record Banks or Personal Health Records work?▲
  When you seek care, you give permission for your healthcare professional to access your up-to-date health records via a secure connection. When care is complete, the new records from that visit are securely deposited—and made available for the future.
• How are Health Record Banks (HRBs) similar to or different from Personal Health Records (PHRs)?▲
  In the past, PHRs like Google Health and Microsoft Health Vault mostly contained data that the consumer entered into the product. Most of the data in HRBs come directly from electronic health records (EHRs) used by healthcare providers (doctors, hospitals, labs, and diagnostic imaging centers) and the data are copies of your professional health records and diagnostic images in those facilities. HRBs can also accept claims data from your health insurance company. HRBs are careful to store and present EHR data unmodified by the consumer so that your next provider can rely that the information in the HRB would be identical to the same information obtained directly from one of your prior providers. HRBs are ideal for data collected from your personal devices (fitness trackers, weight scales, glucose meters, sleep trackers, etc.) and self-reported data via mobile phone apps (nutritional diaries, symptom trackers, etc.). Modern PHRs are now also collecting all these types of data bringing them closer to HRBs. Both HRBs and PHRs can store and display data entered directly by the consumer. Both HRBs and PHRs are managed by the consumer or an agent of the consumer (as opposed to EHRs, which are managed by providers). Also, HRBs automate the process of managing and reconciling the EHR data for the consumer, a challenging task that many PHRs do not take on. So when you encounter "PHR" ask yourself whether the PHR being described accepts copies of professional EHR data and what the PHR does with those data.
• How is my privacy protected?▲
  Only you and those healthcare professionals you designate can access your private health records. You alone decide which records are visible to your healthcare provider. HRBs store data securely using strong data encryption methods.
• Who is the Health Record Banking Alliance™?▲
  We are a 501(c)6 non-profit organization comprising leading healthcare information technology professionals and organizations who are dedicated to promoting and supporting the development of health record banks and personal health records.
• What can I do to help?▲
  Share this site and videos with your friends. Contact your community leaders and representatives to request a health record bank or personal health record in your region. Talk to your health insurance company or employer and tell them the value a health record bank or personal health record would bring to you and to them. Sign up for a personal health record with companies listed elsewhere on this site. Write to your US Representative or Senator and tell them to support HRBs and PHRs.
• Google Health shut down and Microsoft Health Vault is on life-support. Why do you believe that health record banks will work?▲
  There are a number of reasons why health record banks (HRBs) will work when two well-known personal health records (PHRs) did not.
  • The two well-known PHRs relied heavily on consumers entering data about themselves. HRBs rely on getting copies of consumers’ health records directly from their providers.
  • The early PHRs required the consumer to do all the work of collecting, journaling, and entering the data. For example, patients had to type in their laboratory results. Once the consumer indicates who their providers are, modern PHRs and HRBs will automatically collect initial and subsequent copies after each patient visit.
  • The PHRs did not contain data of sufficient importance to warrant providers taking a look. Over time, HRBs will become the dominant source of information about a patient because they collect a copy of the professional data providers keep on their patients.
  • Providers did not have sufficient trust of the information found in the PHRs because most of the data were self-reported by the patient. This is ironic because when a provider interviews a patient, the provider notes in their electronic health record (EHR) what the patient said so a lot of the information in the unstructured EHR notes originally comes from the patient. Modern PHRs and HRBs will use security certificates to show that the information obtained from other providers (versus the self-reported data) is unchanged from the providers’ EHRs’ data.
  • There are now new sources of data (genomics, microbiomics, sensor data, data about social determinants of health, etc.) that are even more valuable when combined with EHR data and self-reported data.
  • Modern PHRs and HRBs present a platform that is more available to mobile apps that will create value for the consumer when running against their personal health-related data.
  • Payment for healthcare is shifting towards pay-for-value and more of the cost of care is borne by the consumer. Both of these facts increase the importance of consumers taking charge of their health and health-related data.
• Patient portals have had limited use by consumers. Why will HRBs be any different? ▲
  • Indeed, the principal business problem faced by PHRs and HRBs is lack of substantial consumer interest in their health records. Most consumers most of the time don’t care about their health records. Medical records remind them of their own mortality.
  • Consumers are more likely to think about the health records of family members they care for. As more folks start shuttling their aging boomer parents around to multiple providers, they will discover how frustrating it is to show up at a new physician who knows nothing of care previously rendered. Or the family member will struggle to collect the records and images for their parent. This demographic group will look to modern tools to help.
  • Millennials are unlikely to be satisfied maintaining their children’s immunization records on multiple hokey, incomplete paper cards. As high deductible health plans increase out of pocket costs, consumers will gradually insist on avoiding duplicate lab and imaging studies by maintaining a copy of everything they purchase.
  • Employees and individuals are more likely than ever to have to change insurance leading to changing their doctors. Individuals and their employers will want to soften the stress of changing insurance by at least collecting all their records in one place so that their new provider can come up to speed quickly.
  • Patients getting care outside of integrated delivery networks are finding that they are having to remember their logins and passwords to multiple provider portals. The logic of a single, unified record that moves with them will become clear.
  • More care will be rendered direct-to-consumer without a face-to-face provider visit. Having authentic, tamper-proof copies of diagnostic lab and imaging studies will assist consumers in getting useful advice from advanced cognitive analytic applications and telemedicine providers.
  • Each year brings a new type of health-related data different from data found in providers’ EHRs. Genomics, microbiomics, personal device data, environmental sensor data, and self-reported data have value in and of themselves and consumers need a place to store and organize these data. Further, these new data types are enhanced by their analysis with traditional EHR data. Patient portals are constrained by the underlying record system they are tethered to. PHRs and HRBs will become the foundation of an application ecosystem where consumer can choose applications that promise them the most benefit. ​​​
• How can HRBs work when there is no current interoperability platform from which to obtain all of a patient's data? ▲
  • There is no question that better interoperability in general will enhance the ability of PHRs and HRBs to obtain complete, accurate, and useful data.
  • Interoperability will never be perfect and it is now time to begin the process of building a person-centered longitudinal health record.
  • Currently, certified EHRs are required to produce a Consolidated-Clinical Document Architecture (C-CDA) for summary of care and care plans. Most EHRs can also produce pdf documents and unstructured text documents. All of these documents are useful for building a person-centered longitudinal health record.
  • Superior PHRs and HRBs will need sophisticated capabilities to reconcile, aggregate, and de-duplicate these multiple documents types into organized lists of problems, prior procedures, family history, medications, allergies, and risk assessments if PHRs and HRBs are going to be useful to the next clinician. This process will get easier as documentation and vocabulary standards are adopted.
  • Natural language processing is getting more sophisticated each year and is proving helpful at extracting discrete findings from unstructured text.
• Can HRBs lessen a provider's burden, especially with their EHRs? ▲
  • IF most of a clinician’s patients have already set up HRBs and IF patients’ HRBs are easily accessible from the physician’s EHR, THEN HRBs can be an effective source of patients’ complete health records and a source of newly acquired data from outside of the physician’s office. HRBs would be faster, more complete, and better organized than trying to get the data from multiple other providers, and thus lessen the provider’s burden.
  • Increasingly, data important to health and healthcare will come from patient sources like mobile devices, personal devices, and mobile apps (PGHD: Patient Generated Health Data). Right now, most physicians do not have an easy way of either seeing those data or bringing those data into their EHR if they ever wanted to do that. HRBs are an obvious choice for collecting, storing, and organizing PGHD. Again, IF most of a clinician’s patients have already set up HRBs and IF patients’ HRBs are easily accessible from the physician’s EHR, THEN HRBs can be a place to view PGHD without bringing them into the EHR - much like when a patient comes to the office with a sheet of paper listing recent blood pressure recordings or blood glucose measurements. The physician looks at the paper, discusses it with the patient, adjusts the diagnostic and treatment plan accordingly, and briefly summarizes in their visit note their assessment of the data brought in on paper. Similarly, a physician could view the data in the HRB, adjust the diagnostic and treatment plan accordingly, and briefly summarize in their visit note their assessment of the data viewed in the HRB. In the future, patients will be collecting most of the important outcomes data and HRBs are a great place to store and visualize the data, without or with importing into the EHR. Either way, the physician’s burden could be reduced.
  • In collecting PGHD on mobile devices, patients can note their symptoms day by day. So that instead of a physician simply asking at the monthly visit, “How have you been doing?” the physician can ask that question but also be able to easily review the patient’s daily accounting of, for example, joint swelling, joint pain, joint stiffness, and overall fatigue, and have 30 days’ worth of daily indicators graphically displayed on a picture of a human outline. One can imagine similar data collection for headaches, depression, abdominal pain, back pain, and so forth. This kind of technology could allow the physician during the visit to more quickly move from information-gathering mode to discussion and education mode and might even shorten their EHR documentation time.
  • Superior PHRs and HRBs will need sophisticated capabilities to reconcile, aggregate, and de-duplicate these multiple documents types into organized lists of problems, prior procedures, family history, medications, allergies, and risk assessments if PHRs and HRBs are going to be useful to the next clinician. This process will get easier as documentation and vocabulary standards are adopted.
  • So HRBs could ease provider burden but there are a lot of dependencies: patients getting HRBs, patients informing physicians of their HRBs, physician EHRs getting patients’ HRB addresses, HRBs effectively sorting, organizing, and reconciling data they receive from multiple provider sources, standardized transfer of PGHD into HRBs, patient willingness to enter PGHD into mobile apps, patient willingness to use HRBs, and national standards for transferring data from HRBs to EHRs. So in the long run, at scale, HRBs could lessen provider burdens but that is a stretch right now.