Saturday, February 23, 2008


Though my previous blog eluded to the importance of having an electronic personal health record (ePHR), finding a good one still takes a bit of research and forethought. While I await patiently to see what Google is about to unleash with their partnership with the Cleveland Clinic, there are a number of ePHRs out there in the market worth exploring already.

The concept of ePHR is great; YOU control the content, update and take charge of the information, and provide this critical information so that your healthcare provider don't miss important details; hence avoid making mistakes. The reality is, ePHRs are in their infancy. There are numerous ePHRs out already, each with different features and business plans. PHRs are not standards-based, and most lack the ability to transport records amongst healthcare providers, hospitals, and pharmacies. Nevertheless, using them now-though labor intensive-can be life saving, if not error preventing. I will categorize the common types of ePHRs out there with some examples, and comment on some of the pros and cons related to these services. For more information on what content to look for in a ePHR, check out

First: the free ones. That is, free for the patient, the person storing the record. I like these the best, because paying to store health records means at some time, people will stop using them. If you have to pay to store your ePHR, where does the information go in the event you can't pay the subscription fee one year. With that said, you wonder....with the free ePHRs who pays for these services?

Well, that's where it gets tricky. Many ePHRs are offered by health insurance companies or employers, the former version often refer to as Payer Hosted Patient Portal. These portals allow patients to access administrative claims data, such as discharge diagnosis, tests ordered, but not necessarily information that you need. Again, these aren't real ePHRs in the true sense. For a privacy freak, these ePHRs are not great options; particularly since HIPPA doesn't apply to ePHRs. With the way health insurance companies denying, refusing to cover, or voiding individual's health plans due to "pre-existing" conditions, as the industry seem to do freely without shame, would you store your complete personal health record on the insurer's ePHR? And when you change health insurance companies, what do you do then? I suppose If you have nothing to hide, and don't foresee changing health plans; these ePHRs might do for now. Just know that you may need to re-do your ePHR later.

Then there are the ePHRs that healthcare systems are offering, or Provider Hosted Patient Portals. Designed to enhance safety, and to build loyalty within the specific healthcare system or provider, many of these types of ePHRs were funded by the marketing departments of the healthcare systems. These ePHRs commonly function more as portals to clinician's electronic health records, than the ePHRs as they should be. For those with access to such portals, I recommend trying one available to you in order to get the information you need, learn the features in them, and see if it meets all of your needs.

The third category is the free Vendor-hosted ePHRs. While many of these are popping up this year, such as Microsoft's HealthVault (beta), Google's version that is soon to unveil, etc. One that caught my attention is the ePHR by The tool is descent, and created with the right intentions; though as a clinician, I find a few areas of deficiency within the ePHR features, e.g, not enough choices under the medical conditions, and no place to enter surgical histories. There are many health tools built in to to allow one to explore one's health status. For a small fee, you can upload documents by fax into you PHR, such as ECGs or other records from your doctors' office. Certainly worth a look to see if it meets your needs. 

Many of these ePHRs will have to find a way to make a buck from advertisers, or other ways of funding the service that may make you wonder if a conflict of interest may exist. One free ePHR that is should be free of such concerns is, a non-for-profit based service and funded by numerous medical associations. Created by healthcare providers for healthcare providers, it's a descent option for now. The information you store is fairly comprehensive. Unfortunately, for a healthcare provider to access your PHR electronically, the healthcare provider has to pay a small subscription fee. This reason alone, is enough to limit it's use. However, users of ihealthrecord can still print a detailed PHR on paper whenever they access healthcare providers.

The forth category are the Subscriptions-based ePHRs, such as Medic-alert ( which is known for their old fashioned necklace/bracelet I.D.s, or American Medical ID, both featuring their online "medical registry."  For emergencies, the benefit of having a bracelet has been proven over many decades--that is if you are fashionably tolerant of wearing one. As an example, I can't even get my mother-in-law to wear one, so her medic-alert bracelet is hiding in a crevice in her purse. A card in a wallet or purse with essential emergency information, and access information to an online portal could work as well.  Then there are numerous other small ePHRs that seemed to have disappeared as quickly as they have appeared.  I'll reserve judgement on the value of these services.

So check them out, and use it for you or your loved ones. Once you choose one to use, make sure you update them each time you see a doctor, change a medication, or get a immunization shot, change your address, etc.