Over the past 18 months, technology companies are jumping into one the biggest untapped frontiers in the economy:  Health care. 

Among the groups taking the leap are Microsoft and Google.  Both have launched products called Personal Health Records over the past 18 months. 

Both Microsoft Health Vault and Google Health, as they're called, allow patients to store their own personal health histories online.  Like all of their other apps, they are both free to consumers. 

Here's how they work: 

1) You create an account (or sign in if you already have an msn or google account)

2) you enter and/or modify you health history and even upload data from devices like blood sugar meters.

3) You can pull records in from medical centers, doctors' groups  or insurers that have agreements with the PHR company. 

 In general, PHRs have received a lot of good press since they were launched.  But a recent story form the Boston Globe has to make you wonder if they're the right solution. 

The story describes a gentlemen named Dave deBronkart (known to many of us who follow health IT as "e-patient Dave," a very tech-savvy guy with an interest in online health.  Mr. deBronkart decided to transfer his medical records from a Boston hospital to Google Health.  When he did, he was shocked to learn he was one very sick man.

According to his hospital records, he had metastatic cancer (he is kidney cancer suvivor), chronic lung disease and an aortic aneurysm. 

Funny thing, though.  He felt absolutely healthy. 

It turns out the problem is that a good deal of the data had come from billing records and not directly from his medical records.  If you know anything about how doctors bill, we use all kinds of codes and associations for those codes that can easily be misinterpreted by your insurer. When that happens, your medical history can get jumbled with a lot of misdiagnoses. 

Hence, Mr. deBronkart is not as sick as Google Health told him he is.

But it's a good case study in health care--consider these scenarios:

• You're a patient with a history of a bleeding ulcer that's now gone, and you end up in the ER with chest pain.  You should get aspirin to unclot your arteries, but if your PHR tells doctors that you have a "GI bleed" you may not due to the risk of worsening bleeding.

• A friend of yours  who uses a PHR is injured in an accident and hasn't updated his records in over a year (even though he's seen his doctor in that time).  How accurate is that data?

In the Globe article, the answer from a representative at Health Vault is that one needs to be very proactive about keeping things up to date and resolving any confusion. 

But that's like saying if you have a bank account, you, and not your bank, are responsible for calculating your balance, scanning images of your checks and calculating the interest in that 6 month CD. 

And that's the problem with PHRs.

Instead, a patients' REAL record should accessible to him or her online, and those electronic medical records (as opposed to PHRs) across the country should just talk to one another like ATMs do.  Finally, docs like me need to keep your digital health history accurate and by updating your medications, allergies, and diagnoses regularly. 

www.rahulkparikh.com

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