Personal Health Records Online? Just Say No!
It's the up and coming health tool, being offered by all the big players for "free" and if you are smart, you will choose to pass it by.
I'm talking about personal health records (PHRs)one keeps online. There are dozens of websites that entice you to upload your personal health information -- yourself -- giving you space to add everything from scans of test results, to photos. Some charge you money. Others -- the big players mentioned above -- offer the service for free. But you, my very smart guidesite visitor, realize there is no such thing as a free lunch.
The problem is privacy and security. PHRs can't be private and they can't be secure, despite what the hosts tell you.
This came up today because I found an announcement that Google is getting ready to roll out it's new PHR application. They follow the lead of Microsoft (Health Vault) and Revolution Health. In addition there are dozens of private companies that offer this service, plus any number of health insurance companies that are trying to encourage their insureds to go online.
[One note here -- I'm talking about records that individuals keep themselves. This is not that same as EMRs which are electronic medical records, which are closed systems kept by doctors' practices, hospitals, and networks. While I recognize there can be security problems with them, they are not the topic I'm addressing today.]
What's the problem? This is an exercise in "follow the money." For those companies that offer the service for free? Well -- you know they have to figure out a way to make money. The same is true for those companies that charge a nominal amount of money. None of these websites provide this service out of the goodness of their hearts.
What does that mean? Despite what any of them tell you, your information is not private. For some of the companies, the information gets "mined" for information and that information gets sold to other companies that want that information. Some (not all) sell plenty of advertising. If you upload information about your arthritis, for instance, you will see ads for arthritis drugs all over the place. If you get frequent headaches and log them in a PHR, you'll find migraine info and maybe even "Head on - apply directly to the forehead!"
Some more unscrupulous companies will sell your individual information. If you have had cancer, and your log that information into your PHR, you never know when that might come up in a job interview, or as you apply for health insurance elsewhere. Scary, right?
Keeping your medical records, even keeping them on your own computer? Great idea. Keeping your medical records online? Fuggedaboutit. From privacy violations to medical identity theft.... no, it really isn't free.
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Photo ©Peter Macdiarmid/Getty Images
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Comments
Dear Trisha,
I am empathetic to the concern expressed in your blog about PHRs – they need to show value (benefit is worth the cost) to the customer, the patient. Everything costs something, as you point out.
At the same time, not all PHRs are the same, and I can’t endorse the blanket statement made in the headline. There are many organizations out there who are providing PHRs for patients specifically to empower them, and doing it as part of the care service. Why? Because empowered patients have better relationships with their physicians and have better health. That’s why the health care system is here and that’s what patients are paying for via their premium dollars.
I am part of an initiative to describe wat’s happening in the market, and my experience is in implementing a PHR in a large non-profit health member-governed health system. I encourage you to take a broader look at what PHRs are doing for patients in a cross section of health systems and then use the information to empower your audience to ask the right questions. There’s a rich body of literature that shows their benefit, as used by millions of patients in the United States.
Here’s to empowering all patients to make the best health care decisions!
Best,
Ted Eytan, MD
Patient Centered Health Information Technology Initiative
http://www.pchit.org
Ted,
You might be interested in my followup series of articles, beginning here:
http://patients.about.com/od/electronicpatientrecords/Electronic_Patient_Health_and_Medical_Record_Keeping.htm
Benefits here:http://patients.about.com/od/electronicpatientrecords/a/EMRbenefits.htm
Trisha
It’s true that free services like MS and google will try to sell your data or to use it for marketing. However, there are paid services which are cheap and will keep your data private or OFFLINE.
I would disagree with your assessment. If there is a paid service the very business model would be threatend if privacy wasnt a top priority. Infact, that is the core value proposition of a paid service to maintain and secure your PHR. I am confused how this is any different than your financial information which millions of people subscribe into online access to their information.