Time to Switch to an Online Personal Health Record?

Google, Microsoft, and others are offering Internet-based records to help you manage your health.

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If you’re like most people, your personal medical record is a multiheaded beast: pieces of information scattered among the offices of multiple physicians, prescription data at a handful of different drugstores, and a manila folder full of receipts and lab reports in an overstuffed file cabinet at home. Now that it's possible to tame the beast, should you? A host of Web-based personal health records, or PHRs, have been rolled out over the past few years, including offerings from Internet heavyweights Google and Microsoft. The pitch: a central repository for all your health information—from family history to lab results to cholesterol readings—gathered from all those disparate sources, and ways to share it with doctors or other people that you deem appropriate. Plus, cool tools that draw on your information to alert you, for example, if you are taking medications that might interact, or to help you track weight loss. But there are cons as well as pros to putting all your personal health information online.

First, some background: The PHR that you can access on your computer as easily as checking your E-mail does not belong to your doctor. She has her own files full of your medical charts, either in digital form or, more commonly, on paper. (And she’s getting a big push from the Obama administration to convert hers to the digital format in what most say is the inevitable national conversion to electronic medical records, which are supposed to improve the flow and quality of information, lower costs, and benefit your health.) Your PHR is your own collection of all or part of this information.

Personal health records are offered by a variety of sources—employers, insurers, healthcare organizations, and companies that aren’t in the healthcare arena. Kaiser Permanente said in April that more than 3 million of its 8.6 million members use its My Health Manager system to access their records, make appointments, look at lab results, and order prescriptions. The Cleveland Clinic also offers its own PHR to its patients for managing information and appointments. Your employer or insurer may also offer you a PHR through sites like Dossia or WebMD. Finally, there are stand-alone sites, including Google Health, Microsoft HealthVault, Revolution Health, and PassportMD, all of which offer PHRs to people whether or not their employers, insurers, or doctors are on board. If your doctor or insurer is on board, some of those sites allow you to transfer information directly to your personal record.

Most anyone can imagine how helpful these online records might prove to be at some point. If you were on a work trip and developed a sinus infection, you could call up a list of your medications so that your out-of-town doctor could check for interactions with the antibiotic he wanted to prescribe. But certain people will find PHRs particularly useful. If you have a chronic condition like diabetes or heart disease that requires active management and a lot of information juggling, you’re an obvious candidate, says C. Martin Harris, an internist and chief information officer at the Cleveland Clinic. Even more helpful for these frequent users is making it a team effort and getting your doc, even if he is still in the era of paper records, to log on once a week or so and look at the data you’ve recorded—say, checking your blood glucose levels to make sure they’re in line. Don’t be afraid to ask him to participate, says Steven Waldren, a physician and director of the American Academy of Family Physicians’ Center for Health Information. “Be a little forceful,” he says. “Say, ‘I’d really like to try this. Can we figure out a way to make it work?’ ” Also likely to find PHRs worthwhile: people who are caring for an elderly relative or parents in joint-custody arrangements who split time with their kids and want access to things like vaccination records.

For those of us with only occasional medical problems, convenience will likely be the biggest factor in deciding whether to use a PHR and, if so, which one. Everyone is busy, and gathering paper records from multiple sources and then manually entering the information is tedious; all but the most tech-crazy users are likely to abandon a PHR unless it makes collecting and managing data easy. Google Health and Microsoft, among others, provide secure access to some health insurers, pharmacies, and providers so you can request and upload your records, saving yourself some work. Even if your doctor hasn’t already moved into the 21st century, those sites can link you to third-party applications like yourHealth (by healthcare services company Unival) that, if you send them your paper records by fax, will scan and digitize them and put them in your PHR. Revolution Health will upload information faxed from your medical providers for free. But elsewhere you may pay for this and other time- and labor-saving applications. The stand-alone PHR company PassportMD, for example, charges an annual fee and then has an a la carte pricing structure for collecting your information for you, including, say, X-rays and CT scans, and putting them into your electronic file.