Wednesday, October 7, 2009

Personal Health Records

Over at the Health2.0 conference today, one of the speakers addressed the use or, more accurately, the under utilization of personal health records, offered by biggies such as WebMd, Microsoft Healthvault, and Google Health.

What's a personal health record? A PHR is a record of your health history, medications, and other therapies including alternative health practices and vitamins and supplements used. How valuable is it? It appears that the PHR is only important if it is accurate and easily obtained.

Methods to create and maintain a PHR vary widely.

Some PHRs are offered as an online service, such as the ones mentioned above. These PHRs are not accessible to your physician, and is only accurate if the client is willing to enter every bit of data and keep the information current. For some, this is a daunting task and one that is easily forgotten.

Others, like mine, are also online but are administered through my HMO. I can go online, use my health record number and a password, and view my medical condition list, my medications, my lab results, records of previous appointments, and upcoming appointments. I can - and frequently do - make appointments online and communicate via email with my doctors for non urgent problems. It lists my care providers and contact information for each of them. I can also refill most of my prescriptions online and have them mailed to my home with no shipping costs.

I have an elderly friend that has devised a PHR of her own. It's not high tech or difficult. She simply takes a folder and a spiral notebook with her to each of her appointments. In the spiral notebook, she keeps a chronological list of appointments and a brief summary if anything important occurred. She has a face sheet on the spiral that lists her health problems, which are considerable, and her medication allergies. She tucks anything that doesn't fall into that category in the folder and periodically sifts through those papers and discards those that are outdated. Brilliant! Her family knows where this folder is in her home, and understands it's value in case of an emergency.

Personally, I am very grateful that my PHR is handled by my HMO. I seriously doubt that I would be disciplined or energetic enough to go online to update my health record. My visits to my doctor always drain my precious energy, and with the accompanying brain fog, after I dragged myself over to the computer, who knows what actually would be recorded?

I have a suspicion that anyone younger than me might feel differently, however. It probably would be pretty easy to grab your blackberry or iPhone and punch in data right in your doctor's office, if the client were motivated by some significant reasons to document their care. If this said client were like my adult kids, however, they wouldn't feel motivated to do so. They're young and healthy and think that they are invincible and will live forever. Ah, to feel that way again....

My husband worked in the Information Technology department for a large clinic awhile back. He changed jobs in 1996, but before he left, was working diligently to devise what they were calling back then a paperless chart. The US Department of Health and Human Services was granted legislation also in 1996 - the Health Insurance Portability and Accountability Act, or HIPPA - that attempted to address privacy issues surrounding these new medical records. This remains a significant issue. Who can know how much and in what detail about my health? These are big questions whose answers require ongoing discussion and refinement.

Bottom line? There's no doubt that for most of us with any significant medical issues, some documentation of our conditions, allergies, medications and therapies is extremely important. How this is achieved remains to be determined.

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