Article 2

“Personally Controlled Online Health Data—The Next Big Thing in Medical Care?”

Steinbrook, R.  (2008) .  Personally controlled online health data—the next big thing in medical care?  The New England Journal of Medicine,  April 17, 2008,  1653-1656.

Summary:

Doctor Robert Steinbrook, in his article published by The New England Journal of Medicine, weighs in on the pros and cons of online repositories.  Steinbrook introduces readers to Dossia, Microsoft Health Vault and Google Health which are described as new ventures meant to provide patients with the ability to store, access, manage and share their personal health records.  Services provided by these online repositories include personal health histories, lists of medications used by the patient, allergies, immunization records, lab test results and records of doctor visits.  Steinbrook poses the question of whether utilization of these services will benefit patients in the form of improved health and lower health care costs or benefit the economy by creating new job opportunities.  The creation of online repositories will require doctors to decide whether they want to interface their electronic patient records with the new patient sites.  This also brings up questions of confidentiality.  Health care providers who use electronic patient records and allow patients to view these online are required to follow the Health Insurance Portability and Accountability Act (HIPAA) which in turn protects patients’ confidentiality.  Online repositories are not required to follow HIPAA rules and therefore are not required to protect patient confidentiality.  According to Dr. Steinbrook patients utilizing repositories would have more opportunities to manage their own health.  Steinbrook lists the advantages to patient controlled health records as improved health, communications between doctor and patient and coordination between health agencies which will in turn help to avoid medical emergencies.    Steinbrook also claims that better coordinated care will result in lower health care costs through the use of wellness programs which will aid in preventative care. 

Response:

This article poses an interesting view on technological advances.  Technology in the medical field is always advancing.  Electronic patient records are nothing new.  Independent websites that allow patients to manage their own healthcare are.  Group Health Cooperative in Washington State has recently created something similar to an online repository.  MyGroupHealth is an online site that contains electronic patient records and resources for patients to manage their own health care.  All patient records within Group Health are easily accessible by health care providers who are involved in a patients care.  Records are shared within offices and therefore no unnecessary time is spent duplicating patient records or tests.  This type of system can be very beneficial for patients as well as health care professionals.  I agree with Doctor Steinbrook that online patient record repositories such as MyGroupHealth can provide patients with improved health by giving patients the resources they need and the access to their personal health information.  I believe that creating online patient records that could be accessed in an emergency could save lives, time and money.  Providing patients with the resources they need to better manage their own care will create a sense of personal responsibility for their own health.  One aspect of online repositories such as Dossia, Google Health and Microsoft Health Vault that I am concerned with is the opportunity for breaches in patient confidentiality.  Personal health records must be kept confidential.  There are benefits and drawbacks to using technology in this way which must be thoroughly worked through before anything is put in place.  I expect to see more doctors’ offices imple