The promise of personal health records is that they will put patients firmly in control of their own health data and make patient-centered care truly possible. Despite what you may read elsewhere, PHRs haven't gained much traction to date, but that hasn't stopped some leading physician technologists from trying to sell the idea to an indifferent public and medical establishment.
"I'm often asked 'but when will this healthcare information exchange technology be able to retrieve all my records from everywhere when I'm lying unconscious in the Emergency Department and cannot give a history?'" Dr. John Halamka, CIO of Harvard Medical School and CareGroup Health System, writes on his Life as a Healthcare CIO blog.
He says Stage 1 of "meaningful use" is about capturing electronic data to build a foundation for health information exchange."The data exchanges in Stage 1 are simple pushes of data from point A to point B--from provider to public health, from provider to provider and from provider to pharmacy. There is no master patient index, no record locator service and no centralized database containing everyone's lifetime health record."
Building an MPI, a record locator and a consent repository for patients to control what information gets shared is one solution, but it's costly and difficult to scale up to handle the needs of a large institution. A simpler way is what Halamka calls the "electronic medical home." He recommends that providers, labs, pharmacies and other data producers push summaries to this patient-controlled hub, which sounds an awful lot like, say, an "untethered" PHR--one not tied to a specific provider and the same kind that has virtually zero traction with the American (and British and Canadian, to name a few) public.
Dr. Bill Crounse, senior director for worldwide health at Microsoft, saw Halamka's post and hailed that approach in his own post on the Microsoft HealthBlog.
"I, too believe this is the answer," Crounse writes. "That is not to say there isn't a role for local or regional exchanges of health information. But putting patients at the center and in control of their data is the model that I believe will get us closest to the vision of the "always available, truly transportable electronic health record for most Americans" advocated by President George W. Bush in his 2004 State of the Union address. We aren't there yet, but the path seems more clear than ever before to me. And some really smart folks seem to agree."
Among those really smart folks is privacy advocate Dr. Deborah Peel, whom Crounse will share a stage with on Oct. 12 in Berlin at the World of Health IT conference, kind of the European version of HIMSS. "Dr. Peel believes, as do I, that the best model for exchanging personal health information is when the patient is at the center and has control over when and to whom information is shared," Crounse writes.