When a central Arkansas woman logged onto her insurance provider’s website to see her medical records, she was shocked to find they included a diagnosis of cancer. She doesn’t have cancer and never has.
She took steps to correct the records.
The incident helps illustrate a basic tenet about the move in the U.S. toward electronic health records: The patient is ultimately responsible for the accuracy and completeness of his health records. An analogy may be helpful here: Being able to pay your credit card online may ease the chore, but you’re still responsible for ensuring your account is credited.
Patient awareness of the online availability of their records appears to be lacking. And healthy people who rarely go to the doctor may find their first view of their online health records — depending on what is included — jarring, but Dr. Roxane Townsend emphasized that patients have always been entitled to view them.
“As a patient, your records have always been available to you,” said Townsend, the CEO of the University of Arkansas for Medical Sciences Medical Center. “But in the paper world, you needed to come to the hospital because the information is yours but the physical record belongs to the hospital. So you would have to make a request.”
Now, however, patients can, or eventually will be able to, access their records from home, from work, from their smartphones.
“I certainly think the younger people are going to take this up much more quickly than the older people,” said Dr. Randal Hundley, medical director of Arkansas Health Group, the physician group practice of Baptist Health System.
The effort to digitize health care records has been underway for years, but it gained new momentum — and qualified health care providers gained financial incentives — with the 2009 passage by Congress of the Health Information Technology for Economic & Clinical Health Act, known as HITECH.
The law spawned a blizzard of acronyms, chief among them EHR, or electronic health record. The acronym relevant to personal health records is, yes, PHR.
A handy website exists to educate patients about the uses and benefits of a PHR: MyPHR.com. It is sponsored by the American Health Information Management Association, which is the trade association for health care professionals involved in, yes, the management of health information.
“Medical records and your personal health record (PHR) are not the same thing,” says MyPHR.com. “Medical records contain information about your health compiled and maintained by each of your healthcare providers. A PHR is information about your health compiled and maintained by you. The difference is in how you use your PHR to improve the quality of your healthcare.”
At their most basic, personal health records can be paper documents: the copies a patient made of the records kept by his primary care doctor, lab results, a list of medications a patient takes. But as the Internet goes, so goes the world, and these documents increasingly are being housed online or in some other digital memory, such as a USB flash drive.
For at least five years, a number of doctors’ offices and hospitals in Arkansas have offered on their websites a “patient portal.” A patient whose primary care doctor is with Little Rock Family Practice Clinic, for example, and his sleep doctor with UAMS can visit their websites and create online accounts through their patient portals. Most portals allow patients to make appointments, view test results, request refills or pay bills.
Health care providers join IT professionals in stressing the importance of patients taking responsibility for the accuracy of their personal health records.
“The PHR is a tool that you can use to collect, track and share past and current information about your health or the health of someone in your care,” AHIMA says. This information can save a patient money and time if, for example, it prevents an unnecessary repeat of a medical test. The information can save a patient unpleasant side effects or worse if, for example, it alerts a doctor or hospital to a potentially dangerous drug interaction.
Some of the most comprehensive and interactive PHRs are being provided by health insurers. Health Advantage, a subsidiary of Arkansas Blue Cross & Blue Shield, has a patient, or “member,” portal on its website. The patient can log on to view his PHR, which includes the option of adding or editing PHR information — a list of allergies, for example. And he can choose whether to allow providers access to his record.
“The response has been great,” said ABCBS spokesman Max Greenwood. “Members love having the ability to see the information in terms they can understand.”
As AHIMA notes, patients are ultimately responsible for decisions about their health. Their use of PHRs can help improve care.
Expert Advice On Creating a PHR
Dr. Roxane Townsend, UAMS: Anytime you’re seen outside your primary care practice, ask for those records to be sent to your primary care doctor so he or she can have the most complete record.
Julie Wolter, member of the American Health Information Management Association and an associate professor of health sciences at Saint Louis University: Seek copies of your health records from anyone who provides you health care. You always have the right to see your records. When visiting a doctor, write down questions ahead of time, bring a notepad and take notes. “Patient portals are great, but I always tell people to start where they’re comfortable.”
Free forms can be downloaded from MyPHR.com.