This is a great abstract discussing electronic medical records. Dr. Tim Sturgill, an emergency room physician put this together, as the emergency room MD would be at the top of the list to want credible patient records, as some patients may only be seen once at the facility, especially if traveling, the case of an accident, you name it, they see it all.

Personal Health Records are quickly going to become a preferred method of transporting this information from doctor to doctor, to hospitals, to clinics, etc. The patients are now being empowered to not only take an interest in their own health care, but also to begin ownership and being a custodian of their records as well. In the last year, Microsoft and Google have been working to make adding patient data to the chart pretty simple and painless.

The best way to find out about how Google Health and Microsoft Health Vault work is to log on and set up an account, or if you just want to explore, set up a dummy account and you can delete it later, otherwise the discussion about PHRs are just that, discussion and nothing is gained in my humble opinion. Get in there and poke around and see what can be made available and if you are a physician, I’m sure you would like having some credible medical information, especially if this is the first visit with a patient. The light bulb will go on when you see what can easily be made available.

I signed up for the additional inbound fax with HealthVault and now I have a phone number I can give to anyone to fax information to me and all I have to do is open up the HealthVault, look at it, and either save it in my documents or if I don’t want it, delete it. I did the fax number as a catch all for those who still rely on faxing, but otherwise it is not necessary, as you can choose what and who to share your information with. At the bottom I have included several posts about vendors who work with Microsoft HealthVault and Google, as well as some pretty major players such as Kaiser and Aetna who can also export medical record information into Google Health and the HealthVault, and the list is growing.

One vendor that was interesting was a lab whereby a patient gets to order up their own labs, included in links below. There are many big time players already signed up as vendors and ready for action. BD

Dr. Sturgill thinks they are a good plan too and here’s his evaluation:

Patient X was contacted by his personal physician yesterday, he reports that his potassium is high. Patient Y is on three medications: the diabetes one, the blood pressure one and the cholesterol one. Patient Z has been vomiting and urinating blood for months and has had several tests performed with unknown results. These are common problems in healthcare. Common, because information is missing at the point of service (”POS). And common, because the information resides in some physical form at some physical location (”silo”).

Some view that the move from paper to “electronic” (actually digital) records will solve this displacement of POS from silo. But changing paper to digital silos doesn’t address the proliferating number of silos. As healthcare moves to the electronic health record (”EHR”)1, every entity will be creating their own EHR that may or may not exchange information in either a compatible or timely manner. Hardware, software, adherence to standards, and a willingness to participate form the walls of these new silos. It is envisioned that the EHRs, residing in these silos, will exchange information through health information exchanges (”HIE”)2.

Patients may change enrollment with health insurers on an annual basis. A change in insurer may change the entities involved in providing the health services. Many patients have no form of third–party payment and may be exposed to a large array of different entities. Here entities3 may be: providers, facilities, payers, regulators, researchers and patients.4

Problem 1. A patient may have health services provided by numerous entities.


Problem 2. Every entity will create an EHR.


Problem 3. Information exchange between entities must be facilitated.


Problem 4. Problems 1–3 multiply the complexity.

Entities × EHRs × HIEs

EHRs are presently defined in content and scope by the entities creating them. This also creates an ownership interest. The total health record for the individual patient is a composite of all the individual EHRs created by all the entities providing services to the patient. The completeness and timeliness of the total health record is dependent upon the ability of the individual EHRs to be exchanged and integrated.

Composite EHR

If the EHRs are defined as subsets of a patient’s PHR and moved from the entities’ silos to a standardized “health cloud,” then the many EHRs are reduced to a singular PHR and there is no need for HIEs.” The patient becomes the owner of the PHR and the entities become “tenants” for the duration of the service relationship.

Health Cloud


  1. EHR as a general category that includes the electronic medical record (”EMR”), computer physician order entry (”CPOE”), etc.
  2. Here HIE is used broadly for any exchange from faxes and email to quasi–utility models.
  3. Here entities are broadly construed to include all that would access EHR or contribute to the EHR.
  4. Patients will want access to different EHRs and will want to create their own health record—the personal health record (”PHR”)

Related Reading:

Healthcare leaders favor personal networks (Personal Health Records) to RHIOs for data exchange

Information on E-Prescribing – Read Up


CVS/Caremark join the Generic Discount Club – Connect information to Personal Health Record Accounts

Google Health Online Services – Connections Beyond Medications – Personal Health Records

Michael Milken and Muhammad Yunus – Discuss Healthcare and the Economy with Charlie Rose

Healthline – Interview with the CEO – Health 2.0

Google Health Vendors you can connect with and import records – Personal Health Recordsimage

Human Health Records on a Chip Not doing so well – Online Personal Health Records could be a better option - add a Kiosk in the Emergency Room

Kaiser Permanente Adds New Online Health Tools for Chronic Conditions – Personal Health Records with more added value

Patients can order up their own lab tests on line with with a referring physician and you get a free PHR to boot

Aetna and Microsoft join forces – Members will now be able to transfer health records to Microsoft Health Vault

American Heart Association and Microsoft HealthVault Unite

Getting Organized With Online Medical Records – Personal Health Records

Patients can view, share health information through new Health Record Banks - Washington

HealthVault Has New Features Including Fax Services for $9.00 a year – Fax to the Vault!

Google Health adds the “Free” E-Prescribing Program from Allscripts to the Health Record

HealthVault Personal Health Records gets a Facelift - Match records and find clinical trials

Standards for Clinical Summaries, Labs, E-Prescribing...

Microsoft HealthVault and RelayHealth (McKesson) to Connect Doctors and Patients

Approval For Wireless Transmitter That Monitors Implanted Cardiac Devices

Personal Health Records – Links to the Websites

AT&T, Covisint, Microsoft HealthVault Create Health Information Exchange

Blues Plan Joins Google Health PHR

Quest Diagnostics and Google Empower Patients and Physicians to Share Diagnostic Test Results Online

St.Jude Collaborates With Microsoft HealthVault


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