A few weeks ago my younger son swallowed a paper clip and ended up in the ER. Fortunately he was fine, but in the course of his care he saw numerous doctors. Then we had the follow up appointment and follow up phone calls with the nurses from his pediatrician's practice. With each conversation I needed to describe what had happened from beginning to end, what kind of care my son was receiving, and what I was told I needed to do for the long term. Being in the ER with a 21 month-old and a 4 year-old obviously wasn't the time of my life. Needless to say, I had a hard time just trying to keep track of where we all were at that moment. Each conversation I had about my son's care caused me to have to pause, and try to remember everything that had happened. Yes, I did get a discharge sheet, but I didn't have a discharge sheet from the pediatrician's office when I subsequnetly had to go back a few days later for more x-rays at the ER.

The American Health Information Management Association (AMHIM) has started a new campaign to enourcage better management by Americans of personal health records. The campaign is called "It's Hi Time America". The idea behind it is for people to have have the information needed to make important medical decisions. I would have had better access to my son's medicalfiles to take with me from doctor to ER. According to the New England Journal of Medicine, Microsoft, Google, Dossia, Microsoft Health Vault are just some of the companies who are moving into the market to offer these types of services.

The New England Journal of Medicine uses the metaphor of an ATM to explain this service saying, "We can travel almost anywhere in the world and find a machine that will dispense local currency, taking the money from our home account with the use of a bank card. Yet, when we go from a primary care physician to a specialist in our home town, we must begin at square one, providing the new doctor's office with all our demographic and medical information, often by completing paper forms."

If I had been using one of these services, after my son got treated, I could have asked the doctor to send his medical information to his on-line account. I could have given the pediatrician's office access to those records, so that it would have been accessible when he received follow up treatment from his pediatrician or follow-up calls from nurses within the office. Sure I could get copies of my son's records, but it's not as easy as it sounds. It takes time for the records to be copied, usually two weeks, and there are forms that need to be filled out. However, despite these inconveniences, there is a seamlessness and a potential improvement to the quality of service when health care records can be shared across multiple providers.

I have enjoyed the benefit of this sort of approach on a smaller scale. My primary care physican has computer access to all my files from the hospital where I gave birth because she is affiliated with that hospital. When I saw her for a phsyical a few months after giving birth, she was able to read my records and thus knew a lot about my current medical situation without me needing to explain everything. I don't have the same level of access to these records, and they are not as portable as records stored by a service that I control, but there are similarities.

Rebecca from Rebbecca's blog wrote a very informative post describing the downside, as well as the upside of these sorts of services. For example, she describes the fact that they are not bound by the various federal legislation protecting the way medical providers protect patient privacy and confidentiality. "The authors say that consumer control of personal data under the new, unregulated Web systems could open the door to all kinds of marketing and false advertising from parties eager for valuable patient information." Another blogger, Furd Log also wrote about concerns about the privacy of the information.

Mark Frisse's Policy Blog sums it up well, looking into how consumers can best protect themselves and enjoy the benefits of these services, despite the risks. He writes "One conclusion is inescapable: the horse is out of the barn. Gradually, these many efforts will coalesce not into a standard "certified product" but perhaps at least a consensus on what is really important policy-making and what is a distraction. With this knowledge in hand, one can address the critical issues surrounding confidentiality, safety, and integrity." I have to agree.

Alex also blogs at Formula Fed and Flexible Parenting