When it Comes to Your Health, Accurate Personal Health Care Records Are Key
Not too long ago, it seemed that personal health care records were something akin to closely-guarded state secrets—getting your hands on even your own information seemed to take an act of Congress and a dispensation of form from the high Pontiff himself. Then along came the internet, and with it, the democratization of information. Now, riding herd on your health care information isn’t so much an issue of access, but one of data liquidity, or ensuring not only that your data is accurate, but expressed in a form that can be digested by you and your health care providers alike.
For example, if you’ve grown weary of filling out those ubiquitous forms each and every time you visit a doctor, you can use a service like NoMoreClipboard.com. Billed as a secure medical “vault” for your important medical records—as well as your kids’ medical records, or the records of anyone (an elderly parent, say) whose health is your responsibility—you can log in and create an account to store all the information you care to enter. That way, the information is there for you to access at any time, and when it comes time for you, or anyone in your charge, to see a doctor, NoMoreClipboard.com will shoot that information over to the doctor for you—for free. And for a fee, NoMoreClipboard.com will even distill that information into the type of form specifically used by your doctor. NoMoreClipboard.com’s database includes every physician recognized by the American Medical Association (AMA). Want more? NoMoreClipboard.com even integrates with Google Health.
About Google Health . . .
Launched in May 2008 as a beta product, Google Health is an opt-in personal health information centralization service that allows users to enter health information about themselves and create a Google Health “profile”—a merged health record that can be consumed by users and health care providers alike. Not only does it allow users to create health records by entering information manually, it allows users to create health records automatically from existing sources. If you’re a member Cleveland Clinic, for example, or if you get your prescription drugs from CVS or Walgreens, you can import information from those sources directly into your Google Health profile.
But be forewarned: the democratization of medical information may be a great leap forward for health care, but it comes with its responsibilities. And those responsibilities fall heaviest on the person who relies on the data the most: the patient.
In April, the Boston Globe painted a vivid picture of what could go wrong when it told the story of Dave deBronkart, a cancer survivor who decided to create a Google Health profile with information he obtained from Beth Israel Deaconess Medical Center in Boston. After importing the information into his Google Health profile, deBronkart was surprised to learn some things he never knew about his cancer: that it had spread to either his brain or his spine, or that he may have had chronic lung disease and an aortic aneurism—or that his blood pressure medication required immediate attention.
The issue? Some of deBronkart’s information was drawn from billing records rather than health records themselves.
Billing records are already computerized, and as a result, they’re easy to download, upload, and transfer. However, they are prone to inaccuracies for several reasons, among them the codes required by insurers, and the notion that sometimes doctors label diagnostic tests with the names of diseases they hope to rule out—not diseases the patient actually has.
“Claims data is notoriously inaccurate and notoriously incomplete with respect to an expression of the problems a person has,” said Dr. David Kibbe, a senior technology advisor to the American Academy of Family Physicians, as quoted by the Boston Globe. As a result, accuracy is often lost in translation. In deBronkart’s case, for example, his cancer had spread to his skull, but there is no code for that, so instead, the hospital probably used the code to indicate metastases to his brain or his spine, according to Dr. Daniel Sands, deBronkart’s primary care physician and the director of medical informatics at Cisco Systems, as quoted by the Globe.
Dr. Roni Zeiger, a product manager for Google Health, noted that he is aware of the issue and is sure that Google Health will improve over time. According to Zeiger, as quoted by the Globe, doctors need to evaluate information based on where it comes from and calibrate treatment decisions accordingly—which they often have to do with paper records anyway.
Until all the bugs are worked out of the system, it’s vital that the end user—patients and those responsible for other peoples’ health care—ride herd on their health care data. On Google Health, people who discover mistakes can delete information, add notes, or ask health care providers to correct problems. Potential e-patients can learn more about managing their health care information online at e-patients.net.
By Robert Pothier