[ Tuesday, June 05, 2007 ]


Personal Health Records -- Risks and Benefits: While waiting for a conference call this morning, I was going through some ModernHealthcare's that had stacked up in my inbox (with their "Daily Dose" emails every day, I'm not as careful to get through the print edition in a timely fashion), and saw a great article on PHRs and why doctors are a little leery of them. Unlike an Electronic Medical Record, which is the physician's or hospital's medical file turned into electronic format, a PHR is a load of patient data that can contain all types of personal information about the patient that wouldn't appear in a physician's office file (or at least not in the office files of every physician that has seen that patient). It is more a "personal" record. Imagine a card in your wallet with a chip in it (or even a chip implanted in your skin) that contains information on your allergies, current prescriptions, past medical history, and the like; it could contain information from lots of different doctors, and even information that no doctor might have (over the counter medication or supplements you take, for example). That would be very helpful if you were in an auto accident and couldn't communicate with the ER staff. But on the downside, if you show up with hundreds of pages worth of information, the ER physicians might have to spend more time reading your past history of pink-eye and childhood tonsilectomies to make sure there's nothing hidden in the PHR that would come back to bite them if something went wrong (which often happens with ER patients).

There's also the issue of GIGO (garbage in, garbage out); if the PHR contains bad information (or even extraneous information, since in some situations every second counts), it could result in worse care than if there were no PHR to start with.

Anyway, the two part article (here and here) is definitely worth a read.

Jeff [9:08 AM]

The concern re GIGO is valid. So is the fact that as an industry, improper health care is responsible for a quarter of a million patient deaths a year. If the electric company fatally shocked that many customers annually, Americans would be right to demand immediate government intervention and oversight.

The fact is, EMR has been a massive failure other than as a source of revenue for vendors. Non hospital market penetration was at 8% in 1994. 13 years later it is approaching 10%. And that's after billion being spent to get doctors to buy EMRs.

The answer is PHR. The cold fact is, if patient's don't care enough about their health to maintain an accurate, portable medical record, Darwin will cull the herd. One may find that observation brutal... but a quarter of a million lives lost to medical misstep every year is equally odious.

An inexpensive PHR that does NOT store medical records on a very vulnerable web site but instead employs an economical USB drive
is a very valid alternative. That said, the software must be truly secure (in the event the drive is lost or stolen) while simultaneously being easily accessible (in case of emergency).

SafeKeyNet is not the only solution, but it is affordable, available immediately and made in America. I know, as a patient, I designed it to offer that safety and security to others as well as myself.
I completely agree with Robert's comments. Our I.C.E. Alert is another tool available to consumers on a USB drive that is encrypted and password protected for all medical, dental, eye and legal records. It also contains a health summary with photo that would be of immediate use to EMT or ER personnel. They would NOT need to cull through years of miscellany.

I'm sorry, but in our experience in dealing with the public and doctors over the past nearly three years with this product, we've seen repeatedly that either office or hospital medical staff just don't want to take the time to evaluate the information contained in a PHR, even if it proves to be helpful.

The culture of the practice of medicine is working against us. Unlike professionals in all other industries, the medical profession is wont to allow change. Robert's statement that in 13 years the implementation of EMRs has only increased by a blip is astounding. Once again, only government regulation, rather than "best practices" will finally see information technology take hold in the medical industry.

Many of us who have toiled to develop these tools did so not for big profits and glory, but because someone we cared for needed a better mousetrap for providing up-to-date health information.

Donald J. Roche, Jr., President
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