To clarify, Carl Christensen is the CIO at the Marshfield Clinic that has led their effort to internally develop an EHR over the last 20 years.

Justin Starren is their very talented researcher that heads their Bioinformatics group.

I’m not disagreeing that patients need to be in charge of their own data, I’m simply arguing that the web is not the platform to do that. The Internet is a wonderful way to exchange data, but it is not the only one and we should not let ourselves be blindsided into thinking that it is the only solution that exists. The Internet can indeed do a lot of harm if the wrong database gets hacked.

Don’t want to beat a dead horse here, but as a consumer, have several decades of experience with what could be consider one-of-the-first commercial personal health record and experienced the same in-the-box mentality in 1985. Peer review of the time dictated that the “patient” should not receive their own diagnostic data. So uniquely personal preventive health went stealth into the oncoming New Age of crystal therapy and spiritualism but my personal health record survived based on subclinical findings.

By the way, the wonderful people at wikipedia tells us that a patient is any person who receives medical attention, care, or treatment. Well, let’s all drive a truck through that definition. The word for patient it states is derived from the Latin work patiens, meaning “one who suffers.” Could this not be a better moniker for the 21st century citizen in the United States that the World Health Organization rated 24th, or an average of 70.0 years of healthy life for babies born in 1999.

Patients of old, circa 2007 usually relinquished their humanity to the “doctor” in charge of their sufferings and received a lifetime longitudinal regimen of miraculous pharmaceutical remedies. The health enthusiast of the New Health Millennium wants to address human conditions before manifestation of suffering but most 21st physicians are not equipped mentally to provide proactive or prodromal care to suffering because there is minimal to no reimbursement incentives. Physicians in this country are some of the best trained and brightest minds in the world but appear to be dependent on pharma best practices for common self-limited to esoteric pathological conditions.

Let’s give this healthcare paradigm shift a chance to succeed or fail but let it stand on it’s own merits of providing the average person, yes us Baby-boomer again, with options for our own health information system (his) rather than relagate that data to monolithic Healthcare Information System (HIS). The prime directive for the Internet can be programmed and mandated by man – Internet Do No Harm!

In my opinion, this is a bunch of hoopla. The web makes little sense in an area where it may not always be available. What would be useful in a world of “consumer-driven healthcare” (gawd I hate that term. Can we at least use “patient-driven”?) would be something equivalent to a smartcard or USB flash drive of your medical record. You need something you can carry with you everywhere.

Of course, for something like that to happen we would need vendors to agree on a standard, and who knows when that would happen. It’s a pipe dream, but it’s a lot more practical than the web-driven mess these vendors are heading for. Microsoft (and probably Google and the whole lot of the PHR promoters) is trying to gain a foothold like they did in the PC world, by snagging the user first and then getting the server sales as kind of an add-on sale. I don’t see it happening that way, but I don’t think that will stop anyone from trying.

To end this incoherent rant, I’d like to add the disclaimer that I haven’t used a PHR myself. Is there anyone out there who has a good personal experience with one to share?