Internet Health Records: Convenience at a Cost?

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There are Web sites that allow you to keep information about your medical treatment online, where you and your doctor can access it easily. An article in the New England Journal of Medicine on Thursday asks if electronic medical records are the next big thing in health care. The answer? When it comes to keeping these records yourself, it depends.

Debbie Witchey is like many Americans: She wants to have all her medical records accessible online. Dozens of Internet sites offer the service, some free, some not.

Witchey knows about personal health records. She's senior vice president of government affairs for the Healthcare Leadership Council, a Washington, D.C.-based lobbying group for the health care industry. It's pushing something different: electronic health records, which doctors and hospitals keep on computers so they're quickly available to any doctor at any hospital. The council doesn't have a position on personal health records, which individuals maintain.

A Personal Experiment

But Witchey, 44, was curious about the benefits of personal health records. She checked out promotional materials from one of the biggest sites, Revolution Health. "I was just about to switch doctors, and one of the things they talked about was how great it was to be able to keep all your records in one place," Witchey says. "I was having to go through the process of getting all my records and moving them around, and I thought, 'Well, this would be a good opportunity to give it a try.' So I signed up."

By filling out a few forms, she was able to get her old records scanned and uploaded onto the site, where she could print them out and bring them to her new doctor.

The doctor reviewed the records and put them into Witchey's file.

Then, during the physical exam, the doctor noticed Witchey's blood pressure was high and recommended medication. Witchey wanted to try diet first. The doctor said OK, so long as Witchey monitored herself closely, which she realized she could do easily on the Web.

"I tracked my weight and my blood pressure on the Revolution Health site, and then I printed it out and took it to her every month," Witchey says.

She weighed herself weekly and took her blood pressure every day, entering the information in a minute or two. The fact that she was paying daily attention helped her a lot, she says. She lost 50 pounds and dropped her blood pressure from 135/105 to 107/71.

A Time-Consuming Effort

For now, Witchey has to input everything she wants on the site — prescriptions, vaccinations, details of hospitalizations — because her doctor isn't connected to the system.

That's one of the drawbacks of personal health records, says medical records expert Joy Pritts of Georgetown University.

"The problem now is getting information from your family physician, for example," Pritts says. Such doctors typically have "small practices, and most of them don't have their health information in electronic form."

So they can't send it to a Web site.

That could change as big companies get involved. Right now, Microsoft and Google are in various stages of developing online medical records systems. Some major employers, including Intel and Wal-Mart, are piloting programs as well. Some health insurers already let you have access to your records, which includes some information from your doctors.

At the moment, however, creating and maintaining a full health record may be a job for the compulsive, Witchey says.

"When I first sat down to sign up and get started, I had this vision that I was going to put all my information in here in one sitting, and I'd be all set and ready to go," she says. "And it quickly became clear to me, there's a lot more time to invest in it than I had originally thought about."

She hasn't put in her records from before 2003, for example.

Privacy Worries

It's too early in the history of medical records for success stories or horror stories to have accumulated. One thing medical records experts are worried about is privacy. Pritts says if you're thinking about signing up for a personal health record, be careful.

"Whether it's on the Internet or it's offered through your employer or your health plan, you should try to really locate the part that tells who they can share your health information with," she advises.

Pritts says it may mean squinting at tiny type, but search for companies that pledge not to sell, trade or share your information. And, she says, you have to hope that no one subpoenas your records, and that the company doesn't go under or get sold.

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