Personal health records: empowering consumers.

By empowering consumers, electronic personal health records (ePHRs, more commonly PHRs) will play a key role in the evolving electronically enabled health information environment. Consumers want to be more engaged in their own healthcare and are seeking out information online. Despite intense concerns about confidentiality and security, they have high expectations for electronic health information. The growth of patient self-management tools for remote monitoring will fuel PHR adoption, if tools and standards are developed that make clinical information understandable to and usable by consumers. The value of the PHR will lie in shared information and shared decision-making, as its components support the continuity of care. Efforts in other countries can provide guidance in helping Americans do what they do best-develop and use innovative technology to serve the American people.

Promoting health and improving health care in a cost-effective manner through a military digital library.

OBJECTIVE: The Virtual Naval Hospital (VNH) is a digital library designed to meet the information needs of U.S. Navy medical professionals. The goal of this study was to determine whether the VNH promoted health and improved patient care in a cost-effective manner. DESIGN AND MEASUREMENTS: An economic analysis determining the costs and benefits from the perspective of the U.S. Navy was conducted. As part of this analysis, medical professionals were surveyed from February to August 2000. RESULTS: Respondents used the VNH for a variety of professional activities (average, 8.2 h/wk). Respondents (70%) thought that VNH usage improved patient care. Medical providers thought it improved their diagnosis (70%) and treatment (60%). Respondents stated that the VNH affected 81 medical evacuations and 668 sick-in-quarter days. Overall content satisfaction was 94%. The VNH had a net savings of $143,848/yr and a cost/benefit ratio of 55.9%. CONCLUSIONS: The VNH has a beneficial impact on the Navy's health care system by improving health promotion and patient care and by being economically cost-effective.

The Virtual Naval Hospital: the digital library as knowledge management tool for nomadic patrons.

OBJECTIVE: To meet the information needs of isolated primary care providers and their patients in the US Navy, a digital health sciences library, the Virtual Naval Hospital, was created through a unique partnership between academia and government. METHODS: The creation of the digital library was heavily influenced by the principles of user-centered design and made allowances for the nomadic nature of the digital library's patrons and the heterogeneous access they have to Internet bandwidth. RESULTS: The result is a digital library that has been in operation since 1997, continues to expand in size, is heavily used, and is highly regarded by its patrons. CONCLUSIONS: The digital library is dedicated to delivering the right information at the right time to the right person so the right decision can be made, and therefore the Virtual Naval Hospital functions as a knowledge-management system for the US Navy Bureau of Medicine and Surgery.