The Personal Health Record - A Means of Containing Healthcare Costs

Employing a personal health record can decrease healthcare expenses because many of the healthcare dollars go toward the generation of information needed to make diagnoses and provide appropriate treatment. With passage of HR. 3590, which will expand healthcare coverage to an additional 32 million persons by 2019, more patients will be establishing new doctor/patient relationships and the flow of health information will most likely increase exponentially.

Although in recent years there has been a push for doctors to adopt and utilize electronic healthcare record programs for management of patient health data in the hopes that there will be a centralized database of patient health information that will minimize treatment errors, the truth of the matter is, most doctors have not adopted the technology, and even if most did, because of the differences in practice and recording styles, a central database would not contain all of the data updated in real-time to meet healthcare needs of every patient in every healthcare setting and situation. Therefore, the best repository of health information is you and your own personal health record.

One scenario illustrating the cost of generating and exchanging medical data is the initial new patient visit to establish a doctor/patient relationship. A physician or other healthcare provider evaluating a patient for the first time needs information provided by the patient which is oftentimes lacking because the patient is not knowledgeable and/or because previous treatment records were not requested, requested but not received, or requested and received but illegible. The new physician will oftentimes need approximate dates of diagnoses, approximate dates and results of prior tests, and approximate dates of hospitalizations with some details of the care which was given. If that information is not available, some doctors will order tests that he or she might otherwise not order had the necessary information been available at the time of the patient visit. The net result is an additional expense for the patient or at the very least another component of healthcare inflation.

Many diagnostic determinations and treatment courses of action are made based on subjective data, i.e. information verbalized by the patient. For example, in evaluating chest pain a doctor will usually need to know when and how the pain started, the location of the pain, the frequency of the pain, the duration of the pain, the intensity of the pain, the quality of the pain (cramping, burning, stinging, etc.), what makes it better, what brings it on, what makes it worse, and other symptoms associated with the pain before deciding whether to admit the patient to the hospital to rule out a heart attack or whether to treat the patient for acid reflux outside of the hospital. Many times however, because patients have not thought about the information in an organized way and/or because of nervousness, patients feel put on the spot when asked certain questions about their symptoms and conditions. By recording information pertaining to symptoms and conditions to be discussed during an upcoming doctor visit, a patient is better prepared for the visit with useful information which can reduce expenses by minimizing over-reliance on testing. Additionally, the recorded information is likely to be more accurate than information which has not been recorded and thus more likely to maximize the quality of healthcare received.

A personal health record might therefore also lower healthcare costs during follow-up or sick visits because a well-designed personal health record software program enables the patient to create pre-visit notes and journal notes about new problems and established problems, which can be printed and carried to the doctor at the time of a visit. Additionally, by updating entries in the personal health record the patient tends to be even better prepared to answer questions that will be presented during an upcoming visit to the doctor.

At the time of the writing of this article the duration of an average doctor visit in the United States is approximately 16 minutes which is fairly generous compared to a county like Holland where it is 8 minutes. Factors which are likely to result in a decrease in the length of doctor visits in the United States include healthcare reform which will increase the number of patients receiving treatment, the shortage of physicians, and increasing medical practice overhead. If the average length of doctor visit in the United States does decrease the number of visits to address a set number of conditions is likely to increase unless more can be accomplished per individual visit.

Implementing and maintaining a personal health record in principle should reduce healthcare cost not only at the time of the new patient visit, but also during established patient visits by shifting the diagnostic emphasis from objective date to subjective data and reducing the number of required visits. The basic means by which utilizing a personal health record can lower healthcare costs is by enabling more efficient generation and exchange of health information.

Disclaimer: This article is for informational purpose only and is not intended to serve as a substitute for medical consultation with a qualified professional. The author encourages users of the Internet to be careful when using medical information obtained from the Internet and to consult your physician if you are unsure about your medical condition.

How to Implement a Computer-Based Personal Health Record

A personal health record (PHR) is a health record initiated and maintained by an individual.  It can be in the form of a handwritten health diary, but in today's information age it is most practical and efficient if it is based on a local computer with functionality allowing the exportation of data to a USB flash drive. Implementing a personal health record (PHR) entails gathering as much information about your past and current health and organizing it in such a way that it can be easily retrievable and reproducible for circumstances that might require its use.

The starting point is to choose a personal health record which will allow you to enter typed information as well as information and official documents such as x-ray reports, laboratory reports and electrocardiograms. Ideally, the program should have a resource to allow you to learn more about your medical condition(s) and should be secure and encrypted with password protection of your personal data. Other desirable features include the ability to store health information about your family members as well as yourself, technical support in using the program, ease of transferring information into it and from it to your health care provider(s) and flexibility in the reproduction of the data. All these factors considered, a local computer-based personal medical records software application is probably the most logical choice.

After choosing a personal medical records software program and installing it on your computer the next step involves locating and gathering all the paper documents you may have in your home or elsewhere containing information about your health. These documents can include immunization records, prescription drug labels, prescription receipts, written instructions from your doctor(s), notes taken by you during doctor visits, office records you may have from your current or previous physician(s), hospital bills, prescription receipts, and copies of superbills from your doctor(s).

Once you have gathered as much information as possible pertaining to your health it should then be entered into the appropriate sections and subsections of the personal health record. The basic informational entry process will require typing, but if you want to include actual official reports such as x-rays, laboratory tests, or electrocardiograms, those documents can be scanned, then copied and pasted into your PHR. If you are fairly technical and want to have some fun creating your personal health record dictating the information using one of the speech recognition software programs such as Dragon NaturallySpeaking or ViaVoice is an alternative which is also more efficient than typing. If you do not want to buy a speech- recognition software program and you have one that came with your computer this would be a good time to learn to use it. If you are even more technical and want to be even more efficient in implementing your personal health record you can dictate your health information into a digital recorder, transcribe it through the voice editor software program that comes with the digital recorder into a word processor program such as Microsoft Word or one that comes with the speech recognition program, then copy and paste it into your PHR. The latter method allows you to document information for entry into your health record in real time, such as when you come across stored records in your home or if you dictate notes during doctor visits.

After you have entered as much health-related information about yourself as you have available, then fully explore the personal health record program, going through all the tabs and sub tabs to see if there is any other information you can retrieve and enter at a later date. You might need to obtain some of this information from your health care provider(s), but since it is not yet commonplace for patients to share the responsibility of maintaining a health record it might be necessary for you to explain to your doctor(s) the benefits of having a personal health record, so as to ease any possible concerns of you being litigious. Also, begin making journal entries regarding new symptoms or developments that need to be discussed during impending doctor encounters.

Once implemented, the maintenance and updating of your personal health record should motivate you to be more involved in your health care and hopefully improve your health.

Seven Reasons to Have a Personal Health Record

A digital personal health record (PHR) is a computer-based software application that allows you to store a variety of personal health information including illnesses, hospitalizations, encounters (i.e. visits and communications), journal information in between doctor visits, medications, allergies, immunizations, surgeries, lab results, and family history. The personal health record differs from an electronic medical record which is a similar application with much more all-encompassing features used by healthcare providers such as scheduling and insurance billing, in addition to the storage of patient health data. Owning and maintaining an up-to-date digital personal health record has many benefits and is the cornerstone of proactive healthcare involvement and better healthcare experiences.

One of the chief reasons to have your health data stored electronically is it improves the quality of healthcare you receive by enabling you to be better prepared for doctor visits, equipped with the accurate and relevant information that your doctor needs to pursue an optimal treatment course. Because that vital data can then be conveyed to your doctor more efficiently, more time can be spent during the visit focusing on diagnosing and treating as opposed to gathering information. The latter fact is of paramount importance given the fact that healthcare providers in general have busier schedules and less time to spend with individual patients.

A digital PHR also ensures the availability of your health information in a legible form and facilitates the flow of that information between your and healthcare provider(s) whether only one physician is treating you or several doctors are participating in your care. Information in the record can be conveyed to your health-care provider(s) verbally, in print out form, digitally on an external medium such as a flash drive, and in some cases via the Internet prior to office visits. This ease of transfer of medical data is vitally important considering the fact that 18% of medical errors are due to inadequate availability of patient information. Moreover, medical records are frequently lost, doctors retire, hospitals or HMOs purges old records to save storage space, and employers frequently change group health insurance plans resulting in patients needing to change doctors and request transfer medical records which are sometimes illegible. Despite efforts on the part of the government to encourage doctors to keep medical records on a computer, i.e. utilize electronic medical records (EMRs) also called electronic health records (EHRs) in order to reduce errors, the fact of the matter is only 5% of doctors keep medical records on the computer and many that have purchased EMRs have never effectively implemented them or continued to use them in their practices.

Another compelling reason to have an updated personal health record is it could save your life. The Center for Disease Control on its annual list of leading cause of death included medical airs which was listed six ahead of diabetes and pneumonia. Approximately 120,000 Americans die each year as a result of preventable medical errors in hospitals, and who knows what the total is including patients treated outside of the hospital. Equally daunting is the fact that most emergency rooms cannot adequately retrieve your critical health information in a time of emergency.

The fourth reason to have a PHR is to reduce your healthcare expenses. Doctors generally use subjective and objective information about you in arriving at a diagnosis and treatment plan. Subjective data is that information which can be expressed by you such as your symptoms, and objective data is that information which can be measured and recorded, such as physical exam findings, x-ray reports and laboratory test results. Many diagnoses and treatment decisions can be based in large part on subjective information obtained from the patient or patient's family, but if sufficient and appropriate subjective data cannot be obtained healthcare provider tend to rely more on objective data including x-rays and lab tests which result in higher treatment costs.  X-rays and laboratory tests are oftentimes performed unnecessarily because they were recently performed but the patient did not know the results or did not even know they were performed, fueling the flames of rising healthcare costs.

The fifth reason you need your personal health information stored in a computer desktop-based application is to ensure the privacy of your information. There are online repositories that will store your health record, but there are definite concerns regarding privacy and the security of your data. By using a computer-based application to store all-important data about your health, you can ensure that the information remains private and secure. If you feel the need for greater security of the data within your computer or that which has been exported to a flash drive, there are affordably priced folder protection software programs which will protect the data by requiring a login. Alternatively, there are also biometric fingerprint reading devices which can be installed on your computer allowing login with a finger swipe.

The sixth reason you should have a computer-based record of your health information is the fact that maintaining a health record is a shared responsibility between the health-care provider and the health-care consumer. If you doubt that, try filling out a health insurance application without recorded health information to refer to. Traditionally patients have relied upon their healthcare providers to know everything about them and to record that information, but in today's era of change and looming healthcare reform, that cruise control approach is rapidly coming to a screeching halt. Just as taxpayers are held accountable for knowing and verifying the information they submit or the information that is submitted for them on their tax returns, healthcare consumers are going to be held more accountable for knowing and verifying what is in their medical record. This will be readily apparent if you are ever audited by the Internal Revenue Service or if you have health insurance benefits excluded after your policy has gone into effect because of pre-existing conditions which were not recorded in the insurance application questionnaire at the time of filing.

The seventh reason to have a digital personal health record is to enhance your doctor/patient rapport and engender mutual appreciation. I can recall those patients who were well-prepared with organized, relevant quality information to provide during their patient encounters and the delight I had in treating them. That type of encounter makes the practice of medicine much more fun and mutually beneficial. On the other hand, the patient, by seeking and obtaining a better understanding of my diagnostic and treatment course developed a greater appreciation for me and my efforts. I trust that your experience will be the same.

With more than 20 years experience treating and evaluating patients I recognize the importance of patients having a good working knowledge of their personal health information, but realize that many times that knowledge is lacking.

Perspectives on Personal Health Record and Their Maintenance for Your Better Health

Most people do not carry medical records when they leave home. They do not realize that in an emergency, which no one can predict, these medical records can make a big difference. In fact, they could save a life. Previous medications, history of allergy to medications, and other significant medical or surgical history can help a physician to optimize treatment. The National Health Council recommends you to keep a personal health record and take it with you to your doctor. It's one thing to document your medical information it's another to know when and how to use it.

The main components of a Good personal health record are:

* Your name, birth date, blood type and emergency contact

* Date of last physical

* Dates and results of tests and screenings

* Major illnesses and surgeries, with dates

* A list of your medicines, dosages and how long you've taken them

* Any allergies

* Any chronic diseases

* Any history of illnesses in your family

Personal health records in paper based format have been used since the beginning of modern health care services. These have several disadvantages as they cannot be accessed rapidly during emergency, difficulties in sharing of these records, security and vulnerable to physical destruction as shown in recent Hurricane Katrina disaster in New Orleans in 2005. These records are also difficult to carry around for the individual when migrating to another medical center or health care provider.

Although there are different methods to record one's personal health, Portable Digital Personal Health Record Storage medias are popular since they offer the advantage to Individuals to enable them maintain their health information at their own computer hard drive or other storage devices. Moreover, these could be made easily accessible to any health care provider by the individual who controls the data.

Electronic management of personal health records were developed in the last 2 decades by several electronic health software vendors. Rapid growth in this sector was noticed during the dot-com bubble era.Today, with the growth of Web 2.0 in the internet, there is renewed interest in Personal health records in electronic format. Many still have confusion about Personal health records (PHR) and Electronic health records (EMR).PHRs are different. EMRs or electronic medical records are developed in Hospitals and medical centers, these legal health records are created and stored in health care settings and patients have no control over these records. They contain the longitudinal medical information of any patient over a period of time. A fully functioning EMR is described as one that includes a clinical data repository, controlled medical vocabulary, computerized provider order entry, clinical documentation or charting, pharmacy management, electronic medication administration record, major ancillary systems (for example, laboratory, diagnostic imaging, cardiology, and so on.) and picture archive and communication systems (PACS).

However, PHRs or Personal health records are created by the individuals and patients can have full control over these records. These can contain in addition to medical illness information, health related information. The models are shrink wrapped unlike the EMRs.They could also include complete demographics of the patient along with essential health insurance details. In addition they could also include record of illness over a period of time.

Personal health records have a useful role to play in health care management. Adopting technologies in health care will significantly reduce the cost and improve the effectiveness of health care delivery. Over prescription of medications, duplication of tests and lack of sharing of medical information among health care service providers has resulted in increased cost of health care in the current era.

Disclaimer: This article is for informational purpose only and is in no way intended to be a substitute for medical consultation with a qualified professional. The author encourages Internet users to be careful when using medical information. If you are unsure about your medical condition, consult a physician.

Ms. Catherine Collins has spent nearly a decade in writing about health care topics. She has published her work on health care management in several leading publications in online media. Her vision is to help people to take care of their health with aid of current technologies.

[http://www.open.medicdrive.org]

Open MedicDrive is a collaborative Wiki for advancing and educating about the role of Health care Information Technology in Personal Health Record Management.



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Benefits of Personal Health Records

Gone are the days when people used to carry their health records in unwieldy files when visiting a doctor. The advances in technology made it is possible to carry the entire documents in pocket-sized devices like CD-ROMs, pen drives and now on dedicated websites who take the responsibility of saving and updating medical data. To keep a track of our medical history and share and use it when necessary, we need to create a personal health record. Let us try to understand what it is exactly and what it can do for us and how can they make our life easy.

A personal health record is the consolidated information related to health; stored and managed by an individual. Today, they are also popularly known as, personal health diary, patient health record, or personal medical records. While the concept of this type of records is not new, it has evolved from a stage when these records were stored by the medical professionals and health care providers; to a stage where each person today is keeping their health records by using various technologies such as websites, personal health software and so on. The primary purpose of these is:

o To keep a track on personal health and

o To help the doctors for providing better care through the valuable health information.

Ideally, it should contain every single bit of information related to your health. The information stored in it may differ according to the software or service providers, but any personal health records will contain the crucial health information. Some of the most common parameters that a personal health record contains are as follows:

o Name of the patient, birth date, blood type

o Date of last physical tests or screenings

o Major illnesses or diseases occurred in past with dates

o List of medicines and dosages taken by you

o Allergies and chronic diseases

o History of illnesses in your family

This piece of information can be very important in case of emergencies and can save your life.

Personal health records have numerous benefits not only to the users but also to the health care systems and physicians. A detailed health record can be used by physicians to take important decisions in time of emergencies. Some of the significant benefits of personal health records are as follows:

o Empowering patients: personal health record allows the patients to access, update and verify their own medical records. With the use of personal health records, one can also set reminders for health maintenance services.

o Improves patient-doctors relationship: this is especially true when you have a family doctor or a physician to whom you frequently visits. Doctors find it easy to communicate with patients who own personal health records.

o Improves patient's safety: As the patient keeps updating their health records, it helps them to identify missed procedures and services, drug alerts, and important test results.

o Delivers efficient care: personal health records also avoid duplicative testing and unwanted or unnecessary services.

o Cost-effective tool: patients can save huge amounts which are otherwise spent unnecessary on malpractice costs.

o Privacy: personal health records can be kept confidential by using passwords. Today, most of us want our health records to be safe and secure in our hands so that no one misuses it. It allow patients to keep their health documents safe and secured.

The list of benefits of maintaining personal health records is never-ending and they are slowly and steadily becoming a basic necessity to keep ourselves and our beloved ones healthy. After all, a small initiative towards health can reap great rewards. So, step ahead and create your Personal Health Record!



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The Personal Health Record - Perfect Companion to Wellness and Disease Management Programs

People are recognizing the importance of "wellness" (getting and staying well) and being active, informed participants in their health management decisions. Patients have a unique central perspective. Personal Health Records help patients and doctors to communicate and interact successfully. As new technology provides increasing opportunities for self-assessment and self-care, participants require convenient ways to keep track of what works and what doesn't. PHRs provide capabilities to record relevant information and keep medical professionals informed. For those seeking high quality, accurate, affordable, efficient and cost-effective healthcare, Personal Health Records are likely to become more and more indispensable.

Not so long ago, I thought that Personal Health Records were a waste of time. I have changed. Personal experiences have gradually turned me into an advocate for everyone to have one. In large part, the need for PHRs has been driven by changes in medical and healthcare technology and practices. With increasing specialization, coordination can become an issue. PHRs provide data to patients and their proxies that enables them to communicate more effectively with physicians and other providers. This leads to better decisions. PHRs are memory joggers. They provide important links between past and future generations, helping to spot trends and enable inherited conditions to be addressed before they become serious and chronic. PHRs can be indispensable ingredients in increasingly popular Wellness and Disease Management Programs. I regularly find new benefits and value from my PHR. Here are things to help you learn and put Personal Health Records in perspective.

First impressions are not always the right ones.

My first experience with health records was to create a list of medical expenses for an income tax return. It proved a disappointing waste of time. After listing all my expenses, I found that I was not eligible to claim a tax deduction. Since that experience, I was ready to dismiss the idea when PHRs were mentioned. Besides my experience, I could not see why anyone would ever need one. I thought doctors kept records for their patients and shared them with those who requested them.

PHRs are important in times of emergency.

When I watched victims of Hurricane Katrina and other disasters talk about losing their health records when paper files were destroyed along with their homes, doctor's offices and hospitals, I started to see value from PHRs. People had lost many different types of personal papers, but loss of health records was the most serious. Without records, it took doctors providing emergency treatment extra time to get up to speed and prepared to treat a patient. Any delay could mean the difference between life and death. If only there were some way for patients to inform their doctors and keep them that way. At the same time, disasters seemed relatively infrequent. I thought of priorities and realized the relatively low probability of needing a PHR to get better emergency care. There must be more reasons to have one. Furthermore, I was not sure what a PHR should contain to make it useful.

Their Value Proposition keeps growing.

As I thought more and more about PHRs, their value proposition grew. I found many ways to use them, making it especially important to have one. At the same time, I have wondered about the overlap between doctor's and patient's records, what each needs to have and how to update each other for the best possible decision-making information. Complicating matters, every doctor has needs, personal perspectives and preferences that differ from those of patients. Doctor's records are highly likely to vary from one doctor to another, and no one is likely to consolidate records unless doctors are part of a group that shares common data services. Nevertheless, I have realized more and more the importance and usefulness of PHRs. They can be essential to promoting and managing Wellness proactively rather than simply making assessments, determining problems, deciding what to do, and reporting and recording results. Their net benefit provides a high potential to gain considerable added efficiency and savings.

A personal experience gave me more reasons to have a PHR and ideas for making one.

In May, 2007, I went to see my doctor about a rash. He prescribed an ointment, but also told me to get a blood test in three months just in case I had Lyme disease. He gave me a form to take to the lab on which he wrote "August 23." This was supposed to be my reminder. Fortunately, he did not specify the year since that same time a year later, I finally got around to the blood test when my wife got one for her annual physical. After having the test, I scheduled my own physical. There was no Lyme disease, but at the appointment I learned that my doctor was retiring and that was to be his last week in the office. At that point, the two of us decided that I should get the exam from whomever I selected to replace him. I wished him well, and he gave me a couple of parting shots (tetanus and pneumonia) before handing me a brown envelope with a copy of my health record as I went out the door. I had asked for it since I decided to find a Primary Care Physician nearer home rather than stay with the doctors who took over his practice. Friends recommended a large medical group with a broad range of specialists a short distance away. For the most part, they provide "one-stop shopping." I found a list of their doctors on my insurance company's website and made a selection. When I went for my first appointment with the new doctor, I found that handing over that brown envelope did not relieve me of any responsibilities that I had to bring him up-to-speed.

Welcome to the New World of Patient Responsibility and Wellness.

Times were different. I knew that my role as a patient had changed when I was handed a clipboard with a very detailed questionnaire to fill out. From it, I realized how much I did not know about my health and that I needed to do something to become more informed. In the meantime, I did the best that I could, starting by answering the easiest questions. There were lots of things that I could not remember and needed to leave blank or provide vague answers. I could tell that the questionnaire was important and asked for a copy so I could try to find better and more complete information before I went back the next time. I also realized that the questionnaire provided insight into what should be in a Personal Health Record. Making a PHR looked like a job for a database. As with a word processor, it would enable me to add information little by little and print out an updated report whenever I went to an appointment.

Fortunately, databases are a specialty of mine.

I have created and maintained many of them for employers and consulting customers. However, there were things on the questionnaire that I needed to know that I had never been asked before. Questions were detailed and specific about my family history, all kinds of things related to my past healthcare, what I had done on my own, including diet, exercise, over-the-counter medications and types, reasons, outcomes and dates of encounters that I had with medical providers over the years. This soon became the tip of a very large iceberg that continually changes. As medicine continues to evolve and has gotten more and more specialized, healthcare has evolved from treating problems to refocusing its emphasis on Wellness. It attempts to anticipate problems and prevent them.

Promoting Wellness implies proactive care and necessitates greater patient involvement.

With the exception of the relatively few inoculations that I have received, most of my care has been reactive, a few broken bones, an almost fatal childhood disease, bee stings, spider bites and the like. First, I usually try to fix things myself. I also realize that collecting and analyzing data can uncover diseases that are inherited and trends in vital signs can warn of impending problems. Having data all neatly organized and consolidated into a Personal Health Record makes it easier for healthcare professionals to see at a glance what is going on. It serves as a checklist to inform and remind them of things that are most important to the wellness of me, the patient. As a patient I try to play a central and active role in collecting and organizing information that will enable others to make informed decisions on my behalf. It helps me to use a convenient, easy-to-use database tool, i.e., Personal Health Record software, to create reports that enable doctors to do their work successfully. Fortunately for me I had the skills to make my own database. Ultimately, I helped to start a new company that developed and markets an improved version. It is a team effort for doctors and patients to use a PHR effectively.

Start PHRs as early in life as possible.

PHRs are perfect for parents with babies. Over the years I have had illnesses and injuries that ideally should have been recorded in a PHR. I have forgotten important details. Some or all past experiences can have a bearing on health, and the care that is needed, years later. When I can, I play catch-up, adding more and more to my PHR as I remember and research the details. The same is true for inoculations. Many childhood diseases have become a thing of the past, but occasionally there are a few cases and people worry that they not have been protected. There are also many more inoculations to keep track of. Some require boosters. For example, at any age, people get boosters for tetanus and annual flu shots. Schools provide questionnaires for parents to fill out for new students and to enable participation in athletics. Although doctors may be asked to sign off on them, parents usually help with the answers. Later as children become adults, they have their own questions and questionnaires to answer. People may ultimately get too old and infirm to manage their own affairs. A PHR can be a helpful reminder at any stage of life although information needs will likely change over time.

Record-keeping focuses on the individual.

Record-keeping must be flexible and able to adapt to a person's changing needs. There is a significant downside to not being prepared for many of life's eventualities. A Personal Health Record, while probably the most important type of information to have, only represents one piece of the personal information we should have to manage our affairs. Records must be "personal" to be effective, focusing on what the user expects to gain from having them and is willing to contribute to the effort. It is easier to think of things that make a record more complete if it is done a little bit at a time over an extended period.

Other Considerations

People look at and do things differently. I thought about my annual tax ritual. Like so many others, I put off reporting until the last possible minute and barely meet deadlines. Because I wait, I invariably have more difficulty remembering and finding all of the information that I need. Consequently, the longer I wait to get something started, the more time-consuming and longer it usually takes. I try to compromise by finding ways that make things not only easier and faster, but also that will not require so much of my time all at once. Not waiting until the deadline means I have less to do at crunch time and am less likely to forget something. The same applies to Personal Health Records except they are always a work in progress. With PHRs, when they are needed, the more complete and accurate they are, the better. Since I realize that mine will never be perfect, I do the best that I can and rationalize that I am much better off than those who do not have one.

Records aren't necessarily kept forever or for as long as we may need them. This is true when we use an on-line service to make a PHR for ourselves. Even if we enter our own data, we will lose access to our data if we change to a different provider (insurance company, pharmacy, medical group) than the one that sponsored the initial web-based PHR tool. There can also be "Retention Policies" that prevent us from getting records years later. Our data may have been purged after a certain period of time even if we stayed with the same provider. Electronic data can also be lost if it is not backed up properly or if all the copies are lost or destroyed. A home database and backup can be lost the same way. Even if a storm is not on the way, it is a good idea to have redundant records widely dispersed. The master can be kept on a home computer or web-based PHR, and copies can be kept in a pocket on a smartphone or flash drive, and also on a remote data backup service.

Technology is unleashing progress everywhere. PHRs and healthcare will continue to improve. Whether it is car care or healthcare, we must do our part. We don't always know what to do, but realize that we should not have a car and only put gas into its tank. The parallels to personal health are things such as eating the right foods and getting regular checkups. We go to different auto centers and specialists and do things ourselves. Things can be overlooked and neglected. It is very unlikely that anyone will have a complete picture of what has happened. Deep down we realize that not knowing or neglecting something, no matter how insignificant, makes us susceptible to problems. Taking a risk is always a possibility. When problems occur or we want to schedule preventive maintenance, logs or records help automobile mechanics and doctors to troubleshoot problems and decide what is best for our cars and our bodies. Fortunately for us, automobiles have improved with more built-in reliability. On the other hand, although healthcare improves, we discover that our bodies are more complicated and challenging than we ever could have imagined. It can take a team of specialists to deal with them. As patients, we complicate matters when we withhold information from our doctors. A Personal Health Record has become an important tool enabling better communications and management of our care. It helps doctors and patients alike. It can keep everyone on the same page and aware of what others are contributing that could compromise their own efforts. We must be forthright with our doctors as well as ourselves.

In Summary: My PHR has changed my healthcare a lot. One will change yours, too.

Little did I realize how quickly longtime practices can be overturned and the impact that a PHR can make on getting the care I need. We are experiencing more and more mobility, finding increasing needs to access personal information whenever and wherever we go. We expect universal availability and security of our data. As care improves and I get older, I have found more ways to benefit from healthcare, but also that I have more decisions to make. Making PHRs for myself and helping loved ones with theirs is proving much more important than I expected. Using PHR software is helpful. I find that doctors are happy to provide encouragement and assistance to those like me who share a Personal Health Record with them. It helps them, too. Doing a little at a time gets the job done. It is well worth the effort.



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