PHRs, EHRs, and Being on the Same Plate

By Trisha Torrey, About.com Guide January 27, 2012

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Two conversations this week remind me that sometimes what we say isn't so bad, but how we say it can really mess things up.

One conversation took place with a gentleman who wanted to talk to me about a business idea. We had a loooong conversation - made longer because we disagreed about PHRs. Except, as it turns out, we don't disagree at all.

PHRs = Personal Health Records - I've written about them, and believe that they are mostly pie in the sky. In my world, a PHR is a record patients keep for themselves, and are rarely used by, and never fed by their doctors or other providers. In fact, that's the definition used by MyPHR, too - a non-profit group that is a thought leader in all things PHRs. The KEY here is that providers don't add any patient records to them; patients must maintain them themselves. And mostly, patients just don't.

In fact, I see so many problems with PHRs, that my concerns almost derailed the conversation until....

Until I realized that we weren't using the term PHR the same way.

He was using PHR to refer to a patient's digital medical record. One patient, one record. That shared-with-every-provider standard that the US is working toward. The one that will contain all our bond fide medical records, that all our providers will feed, and we will have access to. It's the record that I call (and that the industry calls) an EHR or EMR (electronic medical record or electronic health record) - and thus you can see, that our terminology was different. No wonder we disagreed!

Once we figured that out, the conversation went swimmingly.

The second misconception came from a point I tweeted, when my tweet showed up on LinkedIn. A fellow patient advocacy supporter, took me to task because several weeks ago, she and I had that same conversation - that I am not a fan of PHRs. My tweet had heralded the fact that one of my local hospitals had just pulled the trigger for patient access to their own medical records. She felt I was being supportive of something I had told her I did not support. Another misunderstanding between PHRs and EHRs - and more explanations needed. And yes, now we have cleared the air.

So why do I raise this today? The truth is - these points and misunderstandings about PHRs vs EHRs are really very minor. Who cares, right?

But what isn't minor is when you and your doctor aren't using the same terminology, or when what she says, and what you hear (or vice versa) are two different things. Like when she says "three times a day" - and you aren't sure whether that means breakfast, lunch and dinner - or every eight hours. Like when he tells you you'll recovery quickly from minor surgery, and you think you can go back to work, and he means you're supposed to lay low for a week.

What we learn from all this is to be clear -and to ask for clarification. Be concise in your conversation - and ask for your provider to be concise, too. If there could be shades of meaning in something you are told, then ask for more information. Choose your words wisely, too, so they can't be misconstrued.

Here are some points to consider when it comes to communicating with your doctors and other providers clearly - whether the conversation takes place about your body, or your records.