The use of PHRs does change the dynamic with the physician and the patient, said Dr. Rick Kellerman, president of the American Academy of Family Physicians. With paper records, even though the information belongs to the patient, it is strictly controlled in the physician office. Having an electronic record that is potentially much more open to the patient could change how the physician documents information in the chart, he said.
One of the barriers to greater physician acceptance of PHRs is the payment structure, Dr. Kellerman said. Services such as phone calls and coordination of care are not reimbursed, and most physicians do not have the capital to invest in electronic health records that could be linked to PHRs or that could feature patient portals, he said.