Challenges of electronic medical record extracts for a personal health record.

The goal of providing electronic medical record (EMR) extracts is to facilitate patient participation in their healthcare and enhance patient-provider collaboration. There are many challenges in selecting a subset of the information available in an electronic medical record (EMR) for export to a Web-based personal health record (PHR). Critical success factors include perspectives in decision-making about what information to extract and assumptions about how extracted information will be used. Existing hard copy release of electronic medical record information provides a starting point. Guiding principles for the extract selection process include extracting information with meaning for the patient, user-friendly presentation of that information, and identifying how the patient will learn more about the information presented. Since a patient may choose to share their extract, a context is necessary in order for a healthcare team member to make sense of the extracted information. Part of the extract selection process is identifying patient education, clinical adoption, and evaluation strategies. Models and frameworks to guide evaluation are essential for success.