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Sherry Reynolds

The banking system is the best example to look at to discern the direction that ERMs and PHR's will go. Your online banking records are similar to a EHR (with real time data and little opportunity to enter your own information but you can move information - data money to pay bills).

A PHR is like using Quicken. You download from Schwab, the Bank, etc and can add personal notes and additional transactions that don't show up elsewhere. You can't upload to your bank but you can then use the data to do your taxes - which is then validated against your brokerage and banking records.

Some of us are working to develop "health record banks" where you can deposit both EHR and PHR data. We are even using smart card technology to streamline registering new patients (think of how we use a debit card).

The private sector has had 20 years to resolve the problem but hospitals are the biggest purchasers and they have a vested interest in not sharing data.

So either consumers will demand convenience and interoperability or the big purchasers like Medicare and Medicaid will step up to the plate and put it in their contracts. No interoperability? No payments.

John Norris

As was noted, PHR's include a whole lot more than old lab reports.

How about data that the doctor asks the patient to report anyway? Up-to-date family history, medications (and supplements), alternative therapies, record of pain.. there is a lot of data that the clinician trusts the patient to self-report. PHR's could make it much easier for both.


Hello Bruce,
Thanks for referencing my post on Leiber's comments to the reporters at WSJ. Just wish to clarify that yes, the EMR vendors are not adverse to PHRs, as long as they are tethered to that EMR they installed and of course it is their PHR that the customer is using. These tethered systems, while having that direct link to the treasure trove of clinical data, will not be all that useful to a consumer that is dealing with a number of care givers - thus the need for the untethered, independent PHR that resides outside the EMR system.

And as I pointed out in my post, there are some heavy hitters in the medical establishment that support the efforts of Microsoft & Google, so I'm not so sure that Leiber has it right regarding physician views.

The PACS Designer

Since I've been working in the healthcare bleeding-edge space for decades the concern about security of patient information has grown exponentially with the incorporation of the Internet in the healthcare value chain.
Like any personal information, let the buyer/user beware of possible intrusion into their personal life. Since I'm sure there will be many styles of PHR's offered to consumers, just as there are many flavors of ice cream, the end results will vary depending on information, and where it is stored but at least it will give the consumer membership in the evaluation team that can be assembled to treat your medical condition should it need treatment. Since the PHR is intended to be patient driven, why not promote it as a tool to improve the speed and quality of that treatment from a team approach.

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