The PHR: if patients adopt it, will doctors trust it?

Written on April 26, 2008 by Kevin Magee

One of the most intuitive pieces I’ve read thus far on the evolution of the PHR appeared this week in the New York Times Health Blog.

While the benefits of a PHR to the patient seem on the surface to be quite obvious and most of the discussion thus far of services such as Microsoft’s Health Vault have revolved around patient and consumer adoption, Jacob Goldstein turns the discussion on its head and asks “but will any doctor’s trust it”?

A very good question.

Many doctors order new tests at their own labs rather than trust, or take the time to obtain previous existing results. The adoption of an EMR is expected to reduce this pattern of duplication and administration of unnecessary tests by providing a trusted and centrally available repository of medical information. Maintained and administrated by hospitals or government agencies, doctors may at first be apprehensive of accepting data contained in the EMR, however under these circumstances one must expect that eventually adoption rates will reach a tipping point and the EMR will become a common place tool in the doctor’s day to day work flow.

When however the administrator of the PHR is a private corporation such as Microsoft or Google, and maintenance of the data is conducted by the patient, will physicians be willing and for that matter should they, rely on this information to make critical decisions regarding the care of their patients?

Steve Leiber the President and CEO of HIMSS says no:

Physicians aren’t going to trust it. Patients could show up and hand over their memory stick or a Internet address for the files, but doctors on the receiving end might be wary of believing what the records says. “It’s outside a protected chain, the second doctors are going to repeat those tests.

While he doesn’t necessarily take up the cause of the “yes” camp, John Moore at Chilmark Research has posted an excellent rebuttal to the piece noting that HIMSS is very much supported by the traditional EMR vendors and only to some degree by the new and emerging PHR vendors. Whether this has an impact or not on Mr. Leiber’s thoughts on the matter are of course relevant; however the questions he raises are worthwhile and should be asked and investigated by not only patients, doctors, but also the PHR vendors themselves.

Regardless of the immediate outcome of the debate, where such PHR services may prove initially helpful are in areas such as providing a list of allergies and other non critical medical information when a patient presents at an ER, visits a walk-in clinic or other such non routine interactions with healthcare providers. In this case the PHR would complement the EHR of the patient and may in some cases provide significant value to the attending clinician.

References:

The Wall Street Journal Health Blog
How Personal Health Records Could Make Care Less Efficient

Chilmark Research
HIMSS Leader Raises Doubts on PHRs

April 26, 2008 | Filed Under cHealth