Lurking on the fringes of all of the discussion about EHRs is its consumer-oriented cousin, the Personal Health Record (PHR).

The PHR is the patient-centered, and patient owned, version of all of this digital health information.  Goes something like this...

My physician or the hospital has data about me in their EHR.  The pharmacy knows about my medications.  The lab knows about my blood work.  But all of this information is going to find its way to my PHR so I have it all in one place.  It will go with me wherever I go, it will help coordinate my care.  And it will help me proactively manage my health.

Turns out there is a big gap between the vision and reality.  A few problems...

It takes more than technology magic to get information from all of those sources into my PHR.  I, the patient, have to do a lot of work.  In spite of all of the heavy breathing by healthcare visionaries, healthy people just aren't that interested in spending that kind of time managing their health.  They have better things to do.  People who are really sick don't have the energy to process the voluminous data they are generating, and besides, when someone is really sick, the care delivery system is far more attuned to coordinating care, making the supposed value of the PHR less valuable.  People with chronic conditions might actually benefit because they get a lot of care over time and  it generally comes from multiple providers.  But we get back to the problem of how much time I want to spend doing this stuff.

Remember to follow the money.  Some big players, like Google, thought there was a gold mine here.  And some big players, like Google, have made no progress and are quietly reducing their focus and investment in their PHR.  The market has a way of separating truth from misty eyed dreams.

Does that mean patients don't want to deal with online health information?  Not at all.  They are just incredibly practical about what they want to do online.  They want to make an appointment, get their lab results, get a prescription refill, and pay their bill.

Oh, they just want to talk to their doctor's office, but in a more efficient way for these simple tasks.  So they can get back to the kids and dinner and their job. 

Doesn't that seem so dang practical?