Widespread improvements in digital communication, hardware, and software have resulted in positive changes in the healthcare technology landscape and the continued development of patient-facing technologies. According to a viewpoint letter published in JAMA, this is indicative of a mature digital healthcare landscape that may “foster the broad adoption of personal health records.”

Christian Dameff, MD, from the Department of Emergency Medicine at the University of California, San Diego, and colleagues explored the issues, both current and past, involved in advancing the interoperability of healthcare data, whether from personal electronic devices such as smart watches or smartphones, virtual assistants such as Alexa, medical devices such as glucose monitors, or hospital healthcare records.

The authors discussed the unsuccessful early attempts to collect digital patient records at healthcare organizations, as well as current efforts to integrate Apple Health Records into patient portals at 12 healthcare organizations, including UC San Diego Health. The University of California, San Diego, is currently assessing whether this new functionality can overcome previous problems.

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As part of this effort, an anonymous online survey was sent to the first 425 patients at UC San Diego Health who activated the personal health record feature; 96% of the 132 respondents reported that they could connect mobile devices to the platform easily, and 78% were satisfied with their ability to use the feature. However, as the authors noted, such enthusiasm is common among early adaptors. Consumers expect ease of use in their devices, and negative experiences can limit adoption, which was the experience with much of the first generation of commercial personal health records.

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The most recent efforts to facilitate interoperable personal health records was set in motion by the adoption of a new health data standard called Fast Healthcare Interoperability Resources. Using web-based programming protocols to simplify interoperability, Fast Healthcare Interoperability Resources establishes a framework to connect healthcare organizations. The stage 3 requirement became effective on January 1, 2019, to allow patients to connect third-party applications to electronic medical records through the use of an application programming interface.

The authors noted that the continuing development of healthcare technologies by well-established technology companies bodes well for the future, but it remains to be seen whether such innovations will drive down costs and improve overall healthcare outcomes.

Lauren Biscaldilauren-biscaldi


Dameff C, Clay B, Longhurst CA. Personal health records more promising in the smartphone era? JAMA. 2019;321:339-340.