Personal Health Record

In addition to EMR (electronic medical record) and EHR (electronic health record), the latest three letter acronym in this area is PHR - or, personal health record. These are described in a February 4th article from the Associated Press. What's intriguing about PHRs is that they are patient-driven.

Everyone has heard of computer tax preparation software. Well, why not a health record created and maintained, not my doctors or hospitals, but by patients. Hmmmmm...... The article does take a shot at doctors for being slow to accept electronic records (although I do agree that docs have been slow to adapt certain technologies).

Doctors have been slow to switch from error-prone paper records to digital ones, so the trend promises to empower patients to take matters into their own computers.

From the front lines of American health care, I do admit that - every day - I have people bring in their blood sugar log or blood pressure log. They keep track of it on excel or other spread sheet program. Not only do patients print this out and bring it to their visit with them, they also bring color graphs which they print out on their ink jet printers. Quite impressive.

Plus, some of these devices, like home blood pressure monitors and blood sugar machines - they have a memory. So, that my patients can show me their trends for the past few hours, past few weeks, and even past few months. What would stop them from inputting this into their computer to further their personal health record.

While large hospital and insurance networks are making the switch, few private doctors have. And even then, software differences mean one doctor's system can't always share information with another's.

Hence the patient-driven trend. More than 100 vendors, from insurers to free Web sites, offer individuals or families the option of creating PHRs — records that they control.

The programs range from very simple electronic diaries to more comprehensive programs that link directly with doctors or hospitals for direct downloading of formal e-charts.

Computer vendors are taking the lead from pharmaceutical companies - direct to consumer advertising. With hospitals and now patients utilizing computer technology for health records, the community based primary care doc (ie - me) will be forced to make the huge financial investment to implement some kind of electronic record (this computer program will probably not be compatible with either the hospital system or multiple patient systems - then what?).

By the way, there is no doubt that electronic records make things more convenient for the hospital, the patient, the pharmacy, the insurance company, the regulatory agency, and others. But how about the physician? I believe the jury is still out on that one. Plus, if you treat electronic records like pharmaceuticals (Ek!), what is the number needed to treat for one person to benefit? There's an interesting question....