Readiness for PHR, Personal Health Record

A few months ago, I commented on this blog that I wasn't ready to create a personal and electronic health record on the web. Yesterday, I found a change in my thinking and went so far as to log-in to an established Patient Center under the auspices of MinuteClinic. (That's the walk-in health facility housed in many CVS Pharmacies.)

PHRs (personal health records) will be a commonplace item in just a few years, largely due to the federal administration's inclusion of the technology in stimulus funding. Has the national discourse on health care and PHRs influenced my thinking? Assuredly. What was a vague idea a few months ago is now a likelihood for me and millions of others.

What prompted my new action, though? It was a second visit to MinuteClinic (minor ailment) in which the sign-in screen (all electronic at this efficient work station) asked me to permit a default option of follow-up email about a web-based health record. I simply let the default checkmark stand—and then entered my email address via the touchscreen. But the time I reached home, my inbox displayed a message with a link to the online Patient Center.

The self-service sign-in desk at MinuteClinic also carried a small, print flyer about the online option of health records. I took one of those. I didn't actually learn anything from it that I didn't already know. But that small piece of paper contributed to my willingness to follow the link that would soon be in my inbox.

I followed the email link to the Patient Center, where I "registered" with a few factoids and a password. I clicked through my records there. Two visits to MinuteClinic, 5 months apart. The records were identical to the print reports I was given during the appointments.

But I didn't proceed with the next step. That would be the optional "export" of the MinuteClinic records to a PHR at either Google Health or Microsoft HealthVault. Both of those free services carry the word Beta in their logos. That's fair: they would have to be beta at this point.

News reports assure that we'll see a lot of changes between now and 2014 (target year for PHRs). I cannot imagine if the Google and Microsoft repositories will be in place 5 years from now, or what system I may use. Will I choose? Will my insurance provider dictate? Will networks of physicians lead me to a choice? I'm mainly just interested in my half-step yesterday. I think it might be classfied as readiness.

© 2009 Mary Bold, PhD, CFLE. The content of this blog or related web sites created by Mary Bold (www.marybold.com, www.boldproductions.com, College Intern Blog) is not under any circumstances to be regarded as professional, legal, financial, or medical advice. Or education advice. Or marital advice. Or even a tip.

Boomer Health: Flu Shots

Flu vaccine via nasal spray (Flu-Mist) or traditional needle is widely available now. The CDC's official campaign is still a couple of months away but for many of us October is the well-formed habit. Get the vaccine early while it's easy to find. Too, it may take two weeks to become effective so an October inoculation puts you well ahead of the first outbreak.

I'm shopping around for the first time in years, having lost Tom Bold's corporate gift (free shots for employees and spouses) and my campus connection ($20 in the years that I didn't get to Tom's workplace in a timely manner). What I barely noticed at grocery stores in the past—"flu clinic in our pharmacy today"—now looms quite large. And improved. At many groceries and drugstores, the occasional flu vaccine clinic has turned into more frequent and even daily access.

Nearly all the states permit pharmacists to administer the vaccine, now, and so scheduling becomes a matter of making sure the appropriate pharmacist is on duty the day you want the shot. In addition, some pharmacies now have medical clinics on site, typically staffed by Nurse Practitioners. Flu shots, immunizations, strep throat tests, etc., are available on a walk-in basis. Most will file Medicare for you and some will take other insurance, too.

Here's my quick list of flu shot outlets around my town in Texas:

• CVS Pharmacy - $30 (Some stores also offer medical services through Minute Clinic, staffed by Nurse Practitioners)

• Tom Thumb - $28 with a discount for 10% off other purchases, too

• Walgreens - $25 - $30 (with Take Care Health Clinics in many cities but not in my area)

• Wal-Mart (Some stores also have walk-in Clinic at Wal-Mart and also RediClinic, staffed by Nurse Practitioners)

• Denton and Tarrant County Public Health Departments - $20 (waived for seniors)

These online locators may save a little time in researching vaccine availability in your area:

American Lung Association Flu Clinic Locator
Flu Shot Locator by Maxim Health Systems

On a personal note: I'm opting for a Minute Clinic in a CVS. Just because I want to preview the place as a potential source of walk-in health care. ~ Lida

© 2008 Mary Bold, PhD, CFLE. The content of this blog or related web sites created by Mary Bold (www.marybold.com, www.boldproductions.com, College Intern Blog) is not under any circumstances to be regarded as professional, legal, financial, or medical advice. Or education advice. Or marital advice. Or even a tip.

Personal Heatlh Record: A PHR at Google

Boomers will live long enough to see the Internet transform most aspects of our lives. That includes our health care or, pertinent to this blog, our health care records. The 2008 launch of an online personal health record (PHR—that's a standard bit of nomenclature that's been around since the late 1970s) will spur that transformation. It's from Google, of course.

Google Health requires a log-in with a Google account (which is handy for all Google apps, anyway). The site carries the designation of BETA, indicating that some parts are still being developed. Google's history of taking web sites through a beta phase is strong—don't mistake the disclaimer for a warning of shaky software. Nothing shaky here in terms of the technology itself.

But on the subject of disclaimers, you will note that accessing Google Health requires acceptance of policies. We've all become accustomed to checkmarking "I Agree" clauses for web sites but the terms of service should remind users to enter data cautiously. The purpose of this site is data recording, with expectation that users will upload personal and health-related data. The site may suit your purpose along these lines, but we don't have any real sense of how successful this site will be in managing information. I see the data collection aspect as a harbinger for consumer relations with medical providers but, frankly, I'm still looking for a doctor's office that simply will let me make appointments online. Placing my medical records on the web is not yet my priority.

The efficiency of web-based personal records is unquestioned. Just as we have become comfortable with online banking, we'll probably soon become comfortable with online health tracking. If you've thought of the HIPAA consideration, good thinking! As the Google Health site says, HIPAA does not mandate how patients handle their own records. Google conscientiously puts the user in charge of every aspect of the data entered and that includes the user's power to limit access by others. So, if you elect to link your online profile with a pharmacy partner, you will decide if the pharmacy has "write-only" access (pharmacy can add information for you to read, but cannot see any information you have stored in your profile) or "read/write" access (pharmacy can both read your profile and also add to it).

Google Health is not the first online PHR but it certainly could be the biggest (soon). Its growth will depend on how many and what partners emerge from the health community. The number is small enough now that there's plenty of room on screen to display corporate logos. Maybe our indicator of progress past Gen 1 will be when the interface reduces partner listings to text only.

On a personal note: I liked seeing Walgreens and QuestDiagnostics on the Google Health partner list. Those are two outfits that I sometimes use. Yes, I'll track Google Health's progress in signing partners, especially hospitals and doctors and insurance providers. ~ Lida

© 2008 Mary Bold, PhD, CFLE. The content of this blog or related web sites created by Mary Bold (www.marybold.com, www.boldproductions.com, College Intern Blog) is not under any circumstances to be regarded as professional, legal, financial, or medical advice. Or education advice. Or marital advice. Or even a tip.