Admit it. You’d love to have all of your personal health information available to you from a single location that you could access easily and on demand. Whenever you visited a new doctor you could electronically transfer your medical history before setting foot in the office. Instead of asking you to arrive 15 minutes early for your appointment to complete the clipboard filled with the same half-dozen medical questionnaires you’ve filled out before the receptionist simply greets you, offers coffee and lets you know the doctor will be with you shortly. (ok – the coffee may be a bit of a stretch)
This may seem like a dream but it’s the promise of the Personal Health Record (PHR) and it’s a promise that’s very easy to embrace.
The concept of the PHR is obvious. Having all of your personal health records, together, in a digital format that can be controlled by you and shared with family members and physicians at your discretion sounds useful, right?
Of course, there are challenges to be met if the promise of PHRs are to be realized. In my mind those challenges appear primarily at the beginning, where the records are created and at the end, where the records are to be shared.
Dr. Nanette Nuessle, MD FAAP, is a Pediatrician, practicing in Oakland Park, Kansas. Her Fireside Pediatrics uses a cloud-based product called Personal Medicine that combines an Electronic Health Record System with Practice Management and a Personal Health Record for use by the parents of her patients.
Before first seeing a patient she requests that the parents access the PHR system to update their child’s family history and immunization records. Despite the fact that these parents have used computers their entire lives they’re initially hesitant to enter medical information into the PHR system. It takes both prodding and instruction to get the parents to start entering data. Dr. Nuessle does say that once the process begins the parents of her patients quickly get the hang of entering the data and are able to complete their part of the record creation process.
If the parents of young children, who have used computers their entire lives are hesitant to enter data into PHR systems then how are older people, those who are much more likely consumers of health care going to be encouraged to begin the process?
Well one way is to have someone else enter that information for them. Princeton, New Jersey based Zweena, LLC offers a PHR service that combines both a Personal Health Record and the secure, accurate and HIPAA compliant data entry of your health information into a PHR system.
Zweena in effect serves as the interface between the physician and your PHR. John Phelan, the founder and CEO of Zweena told me that “we actually have a nurse on staff and other trained medical coding specialists that are accustomed to going through paper records. They pull out, from each encounter, those data elements that need to be captured and then they re-key those elements into the Zweena health record.”
John offered some additional details on the process by explaining that ” Zweena has it’s own data base and when we create the Zweena Health Record for our clients, we run it through a set of quality checks and then “publish” the newly digitized information to both Zweena and Microsoft HealthVault. This provides our clients with two options to see and use their newly created structured health data.”
I see having the records available through both locations as a very positive feature of the Zweena service. Providing access to your records through either the Zweena system or through Microsoft’s HealthVault ensures access to your records should you choose to discontinue your relationship with Zweena.
Having professionals enter the data for you to create a Personal Health Record is an appealing approach for those who might be initially hesitant to begin entering personal health information. But for those who’d be more comfortable entering the data on their own then NoMoreClipboard.com might be just the answer.
NoMoreClipboard.com is based in Fort Wayne, Indiana and has spent considerable time in the creation of an elegantly designed user interface that connects to a seemingly inexhaustible database of physicians, diseases, symptoms and medicines that make entering your personal data as easy as possible.
I’m a 55-year-old man in good health and was able to set up a NoMoreClipboard account and built a fairly complete personal health record for myself in about 20 minutes. The user interface walked me through a step-by-step question and answer session that was over much more quickly than I would have expected. I was able to complete the process to a level of about 90% without even looking at my existing records. I was only missing some the specific dates for care I’d received and it was easy to add those later when I had my records in front of me.
I spoke with Jeff Donnell, the president of NoMoreClipboard.com and he explained to me that what I was looking at was the consumer version of their product, which is something they offer direct to consumers at an extremely reasonable price – free.
Of course, if you’re not Google it’s difficult to make money selling free products so I asked Jeff how they generate their revenue. He responded by saying that the majority of their sales “come from putting in patient portals, that are sponsored by a physician practice, a hospital or an employer on behalf of a patient population.” He continued by saying “In most cases that portal is branded to the sponsoring organization and usually configured or customized to integrate with the other things that organization has going on like Electronic Health Record systems, or devices for health and wellness.
“By partnering with physician practices and hospitals NoMoreClipboards is able to customize a solution that allows partners to automate patient registration, making it easy for data to flow back and forth, not only from the patient to the provider but also from the provider back to the patient “ Jeff said. He went on to say “We’re also able to automate tasks like appointment requests, prescription refill requests and online bill payment.”
NoMoreClipBoards.com and Zweena are two companies offering PHR systems with completely different ways of successfully creating the personal health record.
Now for the second part of the equation we considered in the beginning of this article. When can we, as patients, expect to be able to transfer data back and forth between a physician or healthcare facility EHR system and our own PHRs?
My personal belief is that we’ll begin seeing that level of integration in three to five years. When I asked for opinions from each of the people interviewed for the story I got varying responses. Dr. Nuessle sees that level of integration coming well after my 5-year estimate. She thinks it could take as long as 10 years. Zweena’s. John Phelan agrees and believes that it will be closer to 10 years before we see more than 50% of medical records in digital format. The most optimistic estimate was from NoMoreClipBoard’s Jeff Donnell who sees it coming much faster saying that “in the next 24 to 36 months we’ll begin to see a rapid uptake in consumer acceptance after which at least half of us in America will be routinely monitoring our health records online, the same way we are now doing our banking.”
PHR systems may very well be something most of us will become comfortable using over the new few years. Just as many of us were hesitant to use ATM machines when they first appeared a few decades ago; there is hesitancy in using PHRs now. But the history of technology tells us that once information becomes digitized we consumers want to be able to access and retain it. Once that happens a tipping point is reached which will lead to rapid acceptance.