Personal Health Records and Electronic Medical Records

Republished with permission from Shannon Martin. The original article is available here.

Personal Health Records (PHRs) are undoubtedly the next wave in our ever expanding “online life”. According to Medicare.gov, “A personal health record (PHR) is a confidential and easy-to-use tool for managing information about your health. A PHR is usually an electronic file or record of your health information and recent services, such as your medical conditions, allergies, medications, and doctor or hospital visits that can be stored in one place, and then shared with others, as you see fit. You control how the information in your PHR is used and who can access it. PHRs are usually used on the Internet so that you can look up your information wherever you are.” Typically the term EMR is used to refer to the records held by other parties (doctor, hospital, insurance company), just like you old medical chart. However, you will often see the terms used interchangeably.

Why is a personal health record good for your health? Most importantly, it allows you to provide the most accurate information to providers, which improves the care they can provide. Knowing your health history and keeping track of medications, concerns, and various specialists and tests is vital in a system that can be quite fragmented. As an elder caregiver, having a good system to help you makes this job so much easier. An electronic health record can be accessed easily from almost anywhere, which is great especially if you travel.

We have provided some questions to ask when looking at your options for an electronic health record system. It is also helpful to think about how you will be using such a system. Are you a family caregiver/healthcare surrogate managing a loved one’s healthcare? Are you at a distance and do you have other family and helpers with whom you need to share information? Are you a person with a chronic illness? Do you use medical equipment that may be able to link with such programs? Are you relatively healthy but very mobile and just wish to have basic information accessible?

The American Health Information Management Association (AHIMA) provides a great website: My PHR with comprehensive information on health records. CMS is running several pilot projects right now for Medicare recipients, and several of the Medicare Advantage Plans are offering PHRs. Medicare and the VA have added the “blue button”, allowing you to download medical records they have for you (claims, etc.). In addition, there are many stand-alone plans and websites where you can purchase and control your own PHR.

Important questions to consider in assessing options for Personal Health Records systems:

1. What are the privacy policies and security features to keep your information from being accessed? Most programs are password protected, but research the level of security and encrypting. Also, if you choose a program offered by a provider or an insurance company, ask to review their privacy practices statement.

2. How is the reliability of the technology? Does their server experience downtime? Do they have redundancy and backup so that you don’t have issues accessing the site any time?

3. How easy is the entry and navigation of information? Are there forms or fields that are easy to complete? How intuitive is it to navigate through the system? Are there limits on how much information you can enter?

4. How do you access the information? Most programs are available online and all you need is a web connection. Some may also have a mobile phone app. that makes it easier to review and access from a Smartphone. You can also create a record yourself and use a USB device or other storage method, but you give up some accessibility and possibly ability to share information with caregivers or different providers.

5. What additional features are offered? Some to consider: uploading and storing documents (i.e. advance directives, scanned copies of tests), sharing access (and allowing limited access/read only to certain parties, emergency only access to basic information), mobile phone apps/add ons, integration with other programs (health/behavioral tracking, medical devices to upload data/communicate), comprehensive programs (for example, that include pages for non-medical but relevant information such as Activities of Daily Living needs, financial/legal information, demographic and family information), and programs designed for family elderly caregivers (for example with shared calendars, secure place to share notes and updates).

6. Portability/what happens if the product is no longer offered? If the company decides they will no longer offer the service, will you be able to export your information/port it to another site?

7. Fees/costs? What are the fees and are they charged monthly/yearly? Is there a start up fee? Is there any limit on access or how much information you can have?

8. What would you want the ER doctor to know about you, or your loved one? And how would you tell them?

Medicare’s website offers some information on choosing a PHR that you may find useful as well: Medicare PHR info.

There are many options for electronic personal health records (to say nothing of your options available offline), so we have not tried to compile a comprehensive list here. Based on your situation and needs, plus a review of the systems using the questions we have provided, there are likely several programs that will help you to be better organized, have access and mobility for your health information.

About Aging Wisely: Aging Wisely offers comprehensive care management and consultation to clients in Florida using Caregiver’s Touch, a system that not only helps them ensure better continuity but provides communication to families and even features a mobile app for those who appreciate that functionality. Aging Wisely’s care managers can help clients gather their medical history and records (and confirm accuracy), help seek further diagnosis/information for family caregivers, organize and create a personal health record, as well as assist at doctor’s appointments and maintain the information and continuity of care. Contact them to learn more.

So far we’ve only published articles about PHRs from Google (Google Health) and Microsoft (HealthVault), but we learned that there are many others, starting with this list of free, web-based PHRs:

AccessMyRecords, AMESMyFile, A Smart PHR, Caregiver Alliance Web Services, dLife, DrGlobe.com, Dr. I-Net, Good Health Network, Google Health, Medefile, myHealthFolders, Dossia, HealthButler, HealtheTracks, Healthgram.com,  HealthString, HealthTracer, HealthTrio, Healthy Circles, iHealthRecord, IQHealth, LifeLedger, LifeOnKey, Medical ID Card, MedicalSummary, MediConnect Global, MediKeeper, MedsFile.com, MyChart, My Doclopedia , HR, MyMediList, MyMedSafe, My Health, My HealtheVet, MyLifeSaver, MyMedicalRecords.com, MyNetRecord.com, OnlineMedicalRegistry, Patient Power, RelayHealth, RememberItNow!, Telemedical.com, VIA, WebMD Health Manager, Your Health Record, ZebraHealth

Since publishing this article over a year ago, the number of PHR systems listed has gone down, and I’ve removed at least a dozen who have gone out of business. So the message is to select wisely and go with one you trust will be around.