Pondering PHRs
After reading
this article on CNN.com, I became curious about my own health information. I visited my health insurer's portal, and after struggling for quite some time to remember the password and user name I used way back when, I got a peek at what health information is available on me online.
It isn't very much. I visited a doctor last July. That's pretty much all that's listed, and since I'm now telling you, Internet, about that, it's obviously not very secret information. It doesn't say that I visited the doctor for shoulder strain (a moving-related injury, and I still can't look at the bulky TV in my bedroom without recalling the ouch that it caused), and it doesn't say what prescriptions I received (large blue and yellow pills that comically reminded me of the ones from the "Dr. Mario" video game. Anyone remember that? And more importantly, does anyone have it and a classic Nintendo I can borrow?).
The CNN article basically tells readers that their health information might be online somewhere, most likely on the Web sites of insurance companies. Like the author of the article, I'm not really sure that I enjoy having the information there, especially since I didn't put it there. But then, I'm not entirely against it either. The insurance company's posting it, and they obviously have my information anyway. They're just sharing it with me now.
The writer also brings up personal health records (PHRs), although she doesn't refer to them as such. I just finished up an article on health record banking for an upcoming print issue. Health record banking is a concept that treats medical record information like financial information, and aims to have a network of banks that compile information that's either entered by the patient or compiled by the bank itself. Google Health and Microsoft's HealthVault loosely fall into the categories of health record banks.
In my interviews for the article, several sources brought up the fact that insurance companies have PHRs that their customers can use. The companies have spent, in some cases, massive amounts of money developing the PHRs, and according to my sources, they're not seeing the best results because people just aren't using them, and users may view the PHRs offered by insurance companies somewhat as the fox guarding the henhouse, so to speak.
That's why people may turn to the PHR offerings of Google and Microsoft, instead, rather than those of the insurance companies, if they are going to use any PHR at all. As mentioned in the CNN article, the PHRs of Google and Microsoft aren't covered by HIPAA. Likewise, other health record banks aren't covered by HIPAA either-they're not covered entities.
William Yasnoff, MD, PhD, FACMI, managing partner of NHII Associates and founder of the Health Record Banking Alliance, noted that the banks, are, however, covered by something stricter than HIPAA, under the Stored Communications Act. Dr. Yasnoff and the others I talked to for the article are all against an expansion of HIPAA to include health record banks, as the expansion would, in their opinions, just complicate things and would actually allow health record banks to be more lax about disclosures.
As HIM professionals, would you be hesitant about putting your information online, as it is not covered by HIPAA? Also, do you maintain a PHR, and if not, why?
I'm not an HIM professional, just a writer who writes about the industry (much like the "I'm not a doctor, I just play one on TV" line). And no, I don't have a PHR. When I think of going back to get my past medical records, I get overwhelmed. I'd have to travel back home, 2 hours away, and try to track down my eye doctors, my numerous primary care providers (I had a lot of different insurance companies when I was younger, which meant a lot of different physicians), my hospital records (a horrible stomach virus and an allergic reaction to a gnat bite, if you were curious) and, if I feel like really keeping the records straight, even records from my pediatricians (two of them). Then there are all of my records from the ‘burbs where I currently live, both hospital, physician and specialist records. Also, I lived in New Jersey for a summer, so I had a physician there. And I'm only 25.
I think for me, a going-forward type of PHR would be best, where I just compile the medical information from here on out, rather than getting all comprehensive. Somehow I don't think the stomach virus I had when I was 8 will have much bearing on my future health, anyway, although the allergic reaction to the gnat might.
And thus, I come back to the beginning of this blog post (see how that worked out?)--keeping health information online. I am willing to do this, but I probably wouldn't choose my insurer's PHR option. I also don't know about storing information with the "big guys," Microsoft or Google. I do hopefully have some time to debate my options. I don't have any medical appointments scheduled anytime soon. However, I am moving this month ... I'll try to steer clear of lifting the TV.
What are your thoughts on PHRs and storing medical information online?