One of the themes of the meaningful use definition is the drive to provide the patient more access to, or control over, their health information. The 2011 objectives call for the ability for both hospitals and physicians (eligible providers) to provide patients with an electronic copy of their health information, while the 2013 objectives take it a step further requiring access for all patients to a personal health record (PHR) populated in real time with health data.
What is the administration trying to accomplish by this push? Is it more accountability on the part of the patient over their information? If so, what will that accomplish? I don’t know about the rest of you, but I’m pretty busy – over the years I’ve taken on more and more tasks that were once performed by others. I am my own travel agent and my own bank teller – but I’m not excited about being my own medical records clerk. True, it took many years for online travel and banking to reach the level of use seen today – but in those examples I could see the upside. I liked to be able to compare prices, and see what seat I could pick on the plane, or what specific features a hotel might have that would appeal to me. In the case of banking, I liked being able to pay my bills without writing out checks, buying stamps and finding a mailbox, or having to race to the bank by 3pm to make a deposit. What do I get if I control my health information? Some value proposition may exist that I’m not aware of, and if not, one will likely emerge – but I just don’t see it yet.
In the meantime, I do see the early requirements around PHR as a distraction from the true priority of health information exchange. Much effort will be required to build local, regional, and national HIEs. The PHR could be a byproduct of a health information exchange – ultimately benefitting from the universal ability to exchange data between disparate care settings. Requiring it up front seems to be putting the horse before the cart – independent of the existence of a value proposition for personal control of the information.
