0.4.6 - ci-build
StandardPatientHealthRecordIG, published by MITRE. This guide is not an authorized publication; it is the continuous build for version 0.4.6 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/personal-health-record-format-ig/ and changes regularly. See the Directory of published versions
A common question that comes up in designing a Personal Health Record is ‘what features should it support?’. This question has been discussed in great detail by past workgroup efforts, and we encourage implementors interested in guidance around which functionality to include to refer to Personal Health Record System Functional Model with provides 93 pages and nearly 1800+ recommendations of functionalities that PHR vendors in the past have agreed ought to be inlcluded in a standard model.
However, for the purposes of this implementation guide, we are going to defer on the question of functionality, and take a more data-centric approach and consider the question in terms of importing/exporting records and data storage buckets. The general idea behind this document is that data will be added or removed from the PHR, either through granular API interfaces or bulk data import/export functions, we don’t care which. However, in either case, we will be using standard data schemas for how the data will be transmitted and stored.
For instance… rather than specify that the PHR must include medication reconciliation functionality, we recommend that a PHR must be able to consume a Continuity of Care Documents (CCD) received from a hospital in .sphr format, and to do so, the data should be specified with FHIR resources, which may happen to include MedicationStatement and other resources produced by a medication reconciliation module. But whether or not the .sphr health record contains a medication reconcilitation or not is left completely up to the implementor. The only requirement for conformance is that if the data is included in the .sphr file, it use FHIR data schemas.
In effect, this implementation guide does not specify what functionality should be included the PHR, but it does specify medical charting format that the record uses. It’s about the folder and record keeping, not the specific contents of the records themselves.
| Section | Header Name | Relevant FHIR Standard | Notes | ||
|---|---|---|---|---|---|
| PH.0 | Protected Personal Health Data | Meta Provenance Communication Consent Engine 50 US State Profiles |
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| PH.1 | PHR Account Holder Profile | ||||
| PH.1.1 | Identify and Maintain a PHR Account Holder Record | ||||
| PH.1.2 | Manage PHR Account Holder Demographic Information | Patient | |||
| PH.1.3 | Manage PHR Account Holder and Family Preferences | ||||
| PH.1.4 | Manage PHR Account Holder Advance Directives | Consent Contract |
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| PH.1.5 | Manage Consents and Authorizations | Consent | |||
| PH.1.6 | Manage PHR Account Status | AuditEvent | |||
| PH.2 | Manage Historical Clinical Data and Current State Data | Argonaut Data Query | |||
| PH.2.1 | Manage PHR Account Holder Originated Dat | ||||
| PH.2.2 | Manage Data from External Administrative Sources | Endpoint CapabilityStatement |
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| PH.2.3 | Manage Data and Documentation from External Clinical Sources | Endpoint CapabilityStatement |
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| PH.2.4 | Produce and Present Ad Hoc Views of the Personal Health Record | PlanDefinition | |||
| PH.2.5 | Manage Historical and Current State Data | Endpoint Subscription |
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| PH.2.5.1 | Manage Problem Lists | Condition | |||
| PH.2.5.2 | Manage Medication List | Medication MedicationStatement |
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| PH.2.5.3 | Manage Test Results | Observation | |||
| PH.2.5.4 | Manage Allergy, Intolerance, and Adverse Reaction List | AllergyIntolerance | |||
| PH.2.5.5 | Manage Immunization List | Immunization | |||
| PH.2.5.6 | Manage Medical History | ||||
| PH.2.5.7 | Manage Surgical History | Procedure | |||
| PH.2.5.8 | Maintain Family History | FamilyMemberHistory | |||
| PH.2.5.9 | Manage Personal Genetic Information | MolecularSequence | |||
| PH.2.5.10 | Manage Social History | Observation Gravity - Social Determinates of Health |
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| PH.2.5.11 | Nutrition and Diet Information | ||||
| PH.3 | Wellness, Preventive Medicine, and Self Care | ||||
| PH.3.1 | Manage Personal Clinical Measurements and Observations | Observation Vital Signs |
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| PH.3.1.1 | Manage Personal Observations and Care | Composition DocumentReference Media Communication Argonaut Scheduling |
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| PH.3.1.2 | Communication with Home Monitoring Devices | Observation Device - Mobile Access to Health Documents |
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| PH.3.2 | Manage Account Holder Implemented Care Plans | CarePlan |
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| PH.3.3 | Manage Provider-Initiated Care Plans | CarePlan Practitioner |
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| PH.3.4 | Manage Medications | Medication MedicationStatement |
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| PH.3.5 | Manage Tools and Functions to Assist Self Care | Argonaut Scheduling Task |
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| PH.3.5.1 | Manage Health Calendar | Argonaut Scheduling | |||
| PH.3.5.2 | Manage Tasks | Task | |||
| PH.3.5.3 | Manage a Registry and Directory of Actors | Practitioner RelatedPerson Person CareTeam |
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| PH.3.5.4 | Manage Reminders | Communication | |||
| PH.3.5.5 | Manage Health Alerts | Communication | |||
| PH.3.5.6 | Manage Recommendations | Communication Evidence DiagnosticReport |
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| PH.3.6 | Population Health and Wellness | Measure MeasureReport |
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| PH.3.6.1 | Public Health Reporting | Measure MeasureReport |
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| PH.3.6.2 | Public Health Risk Alerts | ||||
| PH.4 | Manage Health Education | Communication DocumentReference Media |
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| PH.5 | PHR Account Holder Decision Support | ||||
| PH.5.1 | Manage Guidelines and Protocols | Library | |||
| PH.5.2 | Drug Interaction Checking | Library Medication |
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| PH.5.3 | Care-Related Decision Support | CarePlan RelatedPerson CareTeam |
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| PH.5.4 | Integration with Third Party Clinical Decision Support Services | CDS Hooks | |||
| PH.5.5 | PHR Account Holder Configured Alerts, Reminders, and/or Notifications | Communication Composition Schedule Flag |
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| PH.5.6 | Manage Updated Orders, Recommendations, or Alternative Care Plans | CarePlan ServiceRequest |
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| PH.6 | Manage Encounters with Providers | Encounter Practitioner |
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| PH.6.1 | PHR Account Holder Health Data Derived from Administrative and Financial Sources | Claim Coverage |
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| PH.6.2 | Manage Self-Assessments (i.e., Symptoms) | Condition List |
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| PH.6.3 | Communications Between Provider and PHR Account Holder and/or PHR Account Holder Proxy | Communication CommunicationRequest |
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| PH.6.4 | Data and Documentation from External Clinical Sources | DocumentReference | |||
| PH.6.5 | Provider Assessments | DocumentReference DiagnosticReport |
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| PH.6.6 | Referrals and Referral Process | Communication DocumentReference Task |
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| PH.6.7 | Patient-Specific Care, Instructions, Care Plans, Treatment Plans, Guidelines and Protocols | CarePlan ActivityDefinition |
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| PH.6.8 | Manage Patient-Specific Care and Treatment Plans | CarePlan |
| Section | Header Name | Relevant FHIR Standard | Notes |
|---|---|---|---|
| S.1 | Provider Information | ||
| S.1.1 | Manage Selection of Providers | Practitioner Organization PractitionerRole CareTeam |
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| S.1.2 | Manage PHR Account Holder Provider’s Information | Practitioner Organization PractitionerRole CareTeam |
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| S.1.3 | Manage Health Care Provider Information | Practitioner Organization PractitionerRole CareTeam |
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| S.1.4 | Manage Provider Transparency Information | Practitioner Organization PractitionerRole CareTeam |
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| S.1.5 | Manage Healthcare Facility Information | Organization Location |
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| S.1.6 | Manage Healthcare Facility Transparency Information | Organization Location |
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| S.1.7 | Manage Surveys on the Healthcare Experience | Questionnaire QuestionnaireResponse |
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| S.2 | Financial Management | Claim | |
| S.2.1 | Capture and Read Health Insurance Account and Benefit Information | ||
| S.2.2 | Manage Health Insurance Plan Benefit Information | InsurancePlan ExplanationOfBenefit |
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| S.2.3 | Manage Standard Reporting | Measure MeasureReport |
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| S.2.4 | Manage Ad Hoc Reporting | Measure MeasureReport |
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| S.3 | Administration Management | ||
| S.3.1 | Manage Interoperability of PHR Account Holder Demographics | Person RelatedPerson |
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| S.3.2 | Manage PHR Conditions of Use | ||
| S.3.3 | Manage Legal and other Related Documents | Contract DocumentReference Media |
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| S.3.3.1 | Manage Consents and Authorizations | PACIO - Advanced Directives Consent |
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| S.3.3.2 | Manage End-of-Life Documents and Other Advance Directives | PACIO - Advanced Directives Consent |
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| S.3.3.3 | Manage Documents for Personal Representation | ||
| S.3.4 | Manage Data Masking for Sensitive or Selective Information | ||
| S.3.5 | Manage PHR Output | Bundle | |
| S.3.6 | Manage PHR Data Import and Export | Bulk Data IG | |
| S.3.7 | Manage New, Additional, or Other Use Request | Consent Permission Questionnaire |
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| S.3.8 | Manage Requests for Release of Information | ||
| S.3.9 | Manage Information Views | ||
| S.4 | Manage Other Resources | ||
| S.4.1 | Manage Clinical Research Information | ResearchStudy ResearchSubject |
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| S.4.1.1 | Capture Genomic/Proteomic Data and Documentation from External Clinical Sources | MolecularSequence | |
| S.4.1.2 | Manage De-Identified Data Request Process | ||
| S.4.1.3 | Manage PHR Account Holder Notification of Clinical Trials | ResearchStudy ResearchSubject |
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| S.4.1.4 | Manage PHR Account Holder Enrollment in Clinical Trials or Research | ResearchStudy ResearchSubject |
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| S.4.2 | Registry Notification and Management | Endpoint Subscription Communication |
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| S.4.3 | Manage Donor Information | RelatedPerson BiologicallyDerivedProduct |
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| S.4.4 | Manage PHR Account Holder Education Material Updates | Library DocumentReferences |
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| S.4.5 | Manage PHR Account Holder Reminder Information Updates | Schedule Slot Flag Appointment Task Communication |
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| S.4.6 | Manage Public Health Information | Library | |
| S.4.6.1 | Manage Public Health Related Updates | Library | |
| S.4.6.2 | Manage Access to Public Health Information Resources | ||
| S.4.6.3 | Manage Access to Public Health Knowledge Bases | ||
| S.4.6.4 | Manage Enrollment in Public Health Programs | Coverage ActivityDefinition Organization |
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| S.4.6.5 | Manage Enrollment in Public Health Notifications and Alerts | Communication Subscription |
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| S.4.6.6 | Enrollment in Public Health Surveys | Questionnaire QuestionnaireResponse |