In The News

PERSONAL HEALTH RECORDS

Portable medical data moves beyond discussion phase

It resembles a penlight, attaches to a key chain and can store entire digitized medical histories. And if Wilmington, Del.-based CapMed Corp. has its way, one day thousands of patients will routinely tote the USB-enabled Personal HealthKey along with them. Up to now, portable records have been a topic of discussion, but not much else. Chip-equipped smart cards are hobbled by a lack of hardware and technical standards. Storing health data on the Internet makes patients nervous. And burning records onto credit card-sized CD-ROMs hampers updating. Len Martin, senior vice president and CIO at Lancaster (Pa.) General Hospital, sees CapMed's product as the best of what's available. The 521-bed facility has partnered with the vendor to market its Quicken-style Personal Health Record (PHR) software and its portable HealthKey.

Lancaster General is giving 110,000 copies of the software to its patients and employees, in hopes that some will register the customized application, which links to Lancaster's new Web site. CapMed plans to sell a $30, 8-megabyte version of HealthKey in Lancaster.

Patients can upload records and carry them anywhere--a particular convenience for travelers. "We see a big fit for this product, just for the general consumer," says Wendy Angst, CapMed's acting CEO. And with preinstallation on each device, physicians don't even need to install PHR. (The key won't work with Windows 98 or NT, but drivers are available online to correct the glitch.)

Martin's main interest is leveraging the Web site. Patients can click to the site through the PHR interface and select a physician, print out records and create an emergency wallet card. They can carry the key to an appointment, plug it into the physician's USB port and display HTML-encoded records through the doc's Web browser. (For security features of USB, see "Another Twist on USB," page 25.)

Physicians like PHR's potential, Martin says. "Our physicians are willing to accept patients coming in with printed histories that they can just stick in a chart, as opposed to sitting in a waiting room with them or an emergency room and filling out paperwork."

For and against

Portable health records have important proponents. The Geneva-based International Council of Nurses pushes portability to increase patients' role in their care. When the National Health Information Infrastructure Workgroup met Jan. 27 in Washington, D.C., the Markle Foundation's Philip Marshall cited portability as "an important aspect" of standardizing a "personal health-information data set." And the eHealth Initiative, in part, strives to mobilize medical records.

While they haven't made a big splash, products are emerging. Boston-based CareKey Inc. culls encrypted medical records from insurers, caregivers and patients, aggregating them on central Web servers; the data is released only at patients' discretion. Major vendors, such as Cerner Corp., Kansas City, Mo., and Epic Systems Corp., Madison, Wis., also offer sharable Web records.

With LifeLineCD by Canada's Statum Group, Oakville, Ontario, doctors burn the portable health record onto a credit card-size CD-ROM and give it to patients. PDAHealthWare Inc., Deerfield, Ill., offers Health Empowerment Tools, software that allows patients to carry their records in their Palm handhelds. Other companies offer other variants on the theme.

But there are skeptics. Jocelyn Young, program manager for healthcare research at Framingham, Mass.-based IDC, says the technology isn't yet compelling enough for hospitals to invest in. And how will hospitals cover themselves for liability when patients carry their own information around on portable devices, she wonders.

Jim Klein, vice president and research director at Stamford, Conn.-based Gartner, says problems still outweigh benefits. The Internet clearly prevails, he says. "If you've got records on an Internet site somewhere, you don't have to load any proprietary software anywhere, you don't have to connect anything to this dongle."

Web fears

That view misses a key factor, says Martin: distrust of the Internet. He cites studies showing patients' reluctance to place personal data online. A November 2001 study by the nonprofit Pew Internet and American Life Project, for example, said that because of privacy concerns, 60 percent of U.S. Internet users opposed online medical records--even at secure, password-protected sites. But people already use and trust software on their PCs. "It's not stored anywhere else, and they're not worried about security or confidentiality," Martin says.

Years from now, when standards are adopted for smart cards and they gain momentum, this could all be moot, Martin says. But not now. For the time being, "This little device probably makes as much sense as anything else."