An electronic application through which individuals can maintain and manage their health information (and that of others for whom they are authorized) in a private, secure, and confidential environment. 

The most salient feature of the PHR, and the one that distinguishes it from the electronic medical record and electronic health record, is that the information it contains is under the control of the individual. The definition names the individual as the source of control, but leaves room for others acting in the individual’s interest—their agent or agents—to have control over access to the PHR. An agent may be expressly designated by the individual but not in all cases; examples of an agent acting for an individual include parents acting for children, or, in the later stages of life, children acting for parents.

The individual is distinctively the guardian of information stored or accessible within a PHR. Similar to the role of a librarian, a person managing a PHR decides what volumes of information to include, how they are maintained and ordered, and who can read them or “check them out.” Standards and policy will need to determine if and how individuals can delete or modify information in a PHR that originated from an EHR and how these modifications are communicated to other providers with whom the data in the PHR are shared.

Having control also means that an individual’s PHR can exist independently of the entity that sponsors it; the PHR is portable. This requirement for portability excludes models in which sponsors such as health insurers or health care providers give individuals access to health-related information that is dependent on the individual remaining with that sponsor.

The long-term goal of a PHR is to be a lifelong resource of pertinent health information for an individual. Thus it should have both the depth and breadth of information to enable individuals to become more engaged in their own healthcare as they move from being passive recipients to active participants in their personal health management. The health information in a PHR can be drawn from a broad range of possible sources. Significant sources may include, but are not limited to:

• Health care providers: including hospitals, skilled nursing homes, long term care, and other facilities; pharmacies, lab, and diagnostic facilities reporting test results.
• Health care clinicians: including physicians, nurses, behavioral health professionals, registered dieticians, chiropractors, and other licensed or certified care providers.
• Medical devices: instruments, machines and implanted devices monitoring clinical indices, for immediate use as well as for historical purposes.
• Wellness promoters: entities supplying services or information to generate and maintain good health, such as fitness centers, rehabilitation experts, and complementary/ alternative medicine practitioners.
• Individuals: self-generated information for personal management or information for care providers, including information about allergies, prescribed medications, eating habits, exercise objectives, the progression of an illness or recovery from it, and preferences regarding care in various circumstances.
• Health insurers: information arising from claims for insurance payments, disease management programs recommending certain actions and collecting results, updated information on drugs in a formulary, and other coverage policies specific to an individual.
• Public health: government health departments, disease surveillance and immunization programs, school-based care providers and social workers, and nongovernmental organizations engaged in health and wellness.
• Research institutions: information about opportunities to engage in clinical trials and studies, and recently published results of interest to the individual.

The sum of these and other inputs is a well-rounded picture comprising clinical information, administrative information, and wellness information for individuals to employ and impart to others at their discretion.