The Personal Health Library: Taking EHR design to the Next Level

Abstract

Technology maturation in EHR design has evolved over the years. Formal data semantics and rich knowledge encoded in ontologies lead to new era of personalized precision medicine. Also, Web technologies have enabled EHRs to be transferred and communicated via the Web. Heterogenous healthcare data raises challenges regarding seamless communication and data exchange, but it also provides potentials for AI to empower intelligent mobile Health apps (mHealth) for recommendations, learning, and explanations. Also, evidence-based decision making requires integrating patient preferences and research literature with clinical expertise. Contextual knowledge about patients is also necessary. In this paper, we provide a vision of the key innovative technologies that enabled this evolution and highlight some of the limitations yet to be addressed in current EHR implementations, and we propose a paradigm-shifting design for a Personal Health Library (PHL) that sets the stage for higher levels of maturity in EHR design. We explain how the PHL enables both patients and healthcare professionals to make evidence-based decisions by integrating health data with multi-dimensional non-health data, including observations of daily living (ODL) and population-level Social Determinants of Health (SDoH).