Summary:
• Arizona is part of a Medicare pilot project to keep personal health records online.
• Medicare Part A and Part B records are automatically updated.
• Such records can be life saving in an emergency.

Alison Hughes manages her health care from her home computer.

Hughes, 69, a health policy lecturer at the University of Arizona, was one of the first to sign up for PHR Choice, a pilot program begun in January. The program allows some Medicare beneficiaries in Arizona and Utah to create an online record to keep track of prescriptions, doctor visits and related health information.

Alison Hughes makes a presentation about personal health records to students and colleagues at the University of Arizona.

Photo by Tom Spitz

When the Tucson resident learned she needed cataract surgery, she turned to her personal health record (PHR) and found it to be a wonderful research tool, offering search results from sources such as the online medical database Medline.

“They have great links for any ailment,” she said. “I researched everything I needed to know about cataracts. It’s better than looking things up yourself, because they’ve already done all the work for you.”

Here’s how the program works: Beneficiaries enroll at no charge with one of four private health records providers. Medicare offers an online chart to compare their services. The participant’s Medicare Part A and Part B records for the previous two years are downloaded into their personal file, detailing services received, procedures performed and diagnoses. The Medicare PHR Choice page has links to the four providers selected for the pilot project: GoogleHealth, NoMoreClipboard.com, HealthTrio, and PassportMD.

Participants can enter other information, such as family medical history, test results, allergies and lists of medications and supplements. PHRs also can hold an electronic copy of a living will and do-not-resuscitate instructions.

Betty Gilliam, 76, a retired Phoenix office manager, is an AARP volunteer with the PHR Advisory Committee on outreach and recruitment. “People ask if Medicare will have access to all your files, but I tell them no. Medicare just adds its information into your account. If you decide to cancel your account, the PHR file and all its information is deleted.”

According to Medicare officials, the personal medical information is kept secure because the vendors work hard to keep the data safe. If they didn’t, they would lose business. When users log into the PHR account with a password, the latest Medicare claims information is displayed in their PHR so they can view it over the Internet. When the user logs out, the data remains with the vendor.

Access to a personal health rec­ord can be life saving in emergencies. Gilliam learned this several years ago when her husband lost consciousness in the emergency room after a bad reaction to an injection. “They started asking me questions I couldn’t answer. I realized how important it was for family members to be ready with medical information on their loved ones.” Doctors can access PHRs with the patients’ permission.

Although only about one-fourth of consumers keep any sort of personal health record—including paper ones—the use of PHRs is expected to grow as more medical providers store records electronically. For example, Quest Diagnostics, which provides lab services around the state, allows PHR Choice participants to download laboratory test results. Several pharmacies allow downloads of prescription data, and other health providers such as CVS-based Minute Clinics have also signed on.

The pilot was scheduled to end in December, but Medicare officials have decided to extend it through 2010. AARP Arizona supported the extension. When the program ends, the approximately 1,000 Arizona participants will be able to keep their records with the provider at no cost. About 540,000 Medicare beneficiaries in Arizona are eligible to participate in the pilot.

Other PHR pilots have been tried around the country since 2006, including in Arkansas, Louisiana, Pennsylvania and South Carolina, but Medicare has not announced whether it will take the program nationwide.

David Sayen, regional administrator of the Centers for Medicare and Medicaid Services, Region IX, sees PHR Choice as a way to allow consumers to be more active in their health care. In addition to benefiting consumers, a personal health record can also be of value to providers. “It offers support for what the doctor is trying to do,” Sayen said.

Personal health records can also make things easier for caregivers. “They can check the health record and make sure that the patient has taken all necessary meds,” he said. “They also make it easier to refill prescriptions on time.”

As Alison Hughes sees it, “Innovation is exciting. I feel very comfortable with my PHR. It’s easy to enter information. You choose who accesses your records. You don’t have to fool around with looking for things. It’s all in one place.”

Kathryn Lance is a writer and editor living in Tucson.