For quite some time, I have been concerned that my healthcare records, more commonly known as Personal Health Information (PHI), are following me in my increasingly mobile lifestyle and available to me on-demand and need. I write this from the perspective of a relatively healthy “senior” citizen (wow, that’s the first time I have written that moniker about myself – daunting, indeed).
While healthy, I have acquired a great deal of PHI in these greatly appreciated years. It does not take a “brain surgeon” to arrive at a position that one’s PHI would be highly useful when seeking care for a new health event or an existing health condition in a new provider environment. Add to that hypothetical one may be seeking that care in another geographic area, a significantly different time zone, in a land of a foreign language, and/or in a very different delivery system. The aforementioned attributes put further light on the need to have on-demand access to one’s PHI, but let’s complicate the scenario a little more. What if this hypothetical patient needing treatment was not conscious or otherwise unable to communicate their PHI? I propose that the chance for an optimal outcome ibn this hypothetical is at further risk. PHI is essential for the best analysis and decision making. In an emergency treatment situation, PHI must be also be readily available on demand.
In 2009, as I was transitioning from a 30-year career with the US Department of Health and Human Services (HHS), I began to develop the concept of a platform to house one’s PHI and have it available on demand. The concept included a feature where the individual would wear a bracelet or some other identifying vehicle that would provide platform contact information to an urgent care team so they could start the process of gaining access to the patient’s PHI. While the concept never made it off my “drawing board,” it did broaden my understanding of the need for on demand access to one’s PHI. Over time, several PHI storage and access platforms have surfaced. Several of my providers use MyChart. A couple others use Healow or a litany of in-house patient portals. My personal use of several of these platforms provides me with encouragement we are moving in the direction we need to move.
The problem with the plethora of PHI storage and access platforms in the present day is their limited or non-existent interoperability. Some platforms, such as MyChart, allows the user to link their account to multiple participating providers. Of course, the operative word is “participating” providers. I have seen several interesting sharing events of select PHI between providers that I did not overtly, or knowingly, request. While I propose this discussion on the premise that having PHI available on-demand is essential to quality decision-making when seeking treatment, I am sure we all share the concern of privacy of our PHI. So, as much as I want the benefit of the information-sharing, there is a natural reaction or concern to seeing the information shared without directed action by the owner of the PHI to share it.
There is a delicate balance between the value and benefit to sharing personal health information between providers, and the concern of one’s privacy to some of the most personal information about a person. Having the historical record of one’s prior health concerns, treatments, immunizations, medications, test results, and the like can be essential to making the best assessments in a current treatment event, however, that same private information can be detrimental to an individual in so many ways that you can imagine.
I look forward to the discussion that I hope will ensue and appreciate, in advance, learning and growing from the collective experience and knowledge.