Individuals are the best gatekeepers of personal health management
- 09/02/2008
The challenges to developing such a system are numerous and real, though not insurmountable. They include privacy concerns, cost and the complexities of connecting a historically fragmented network of health care providers ranging from doctors, hospitals and surgical centers to laboratories, imaging centers and pharmacies.
While the concept of having all of a patient's medical records stored in one electronic location has great appeal, an EMR is still very much an artifact of the medical world, of greatest practical use to other medical professionals for medical purposes in the interest of the patient: sharing diagnoses and treatment plans, X-ray and test results, surgical notations and office visit data.
Another form of stored electronic data that is available, accessible and of immediate value to an individual is called a personal health record. These electronic records permit individuals to record, track and update their own medical information, the kind they need on a day-to-day basis, for their own knowledge and often to provide to caregivers at appointments or in the event of an emergency.
Most people think they are doing pretty well if they see their doctor once a year for a regular checkup. But what happens in between those visits, and who is keeping track? There may have been a trip to the urgent care center for a sprained ankle, flu shots at the local pharmacy or a health screening at the office that indicated high blood pressure. The family doctor may not be aware of any of these events.
For just such reasons, BJC HealthCare developed a personal health record two years ago called myHealthFolders. The confidential and secure online record was created as a free benefit for BJC employees.
BJC also offers it to other companies that are willing to provide it as a free employee benefit. Currently, more than 20 local, regional and national businesses and associations provide myHealthFolders to more than 3,000 employees holding more than 8,000 family members.
Unlike some other personal health records, myHealthFolders is free and is managed completely by the employee. Employees are encouraged to add information about spouses, children, parents and other family members regardless of whether they are all on the same insurance plan. Additionally, myHealthFolders is accessible from anywhere in the world and is a lifetime benefit that is transportable even if the employee changes jobs. Another valuable benefit is a printable wallet card that enables emergency responders to quickly and easily access the patient's personal health record in a crisis.
Health care is a complicated landscape to navigate and, as pointed out in the Money & Medicine column on Aug. 22, patients usually receive care from numerous providers who have no link to one another — only to the patient. Patients are in the best position to manage their personal health information and that of their children, aging parents or others they support. They also have the most to gain.
Why would BJC develop a personal health record? As both a health care provider and an employer, we have a unique perspective. We see too many preventable health conditions at our hospitals every day, and see those same trends among our own employees. We are aware of Missouri's dismal health scores as compared to the rest of the United States, ranked No. 37 overall in the most recent Commonwealth Fund study.
The high rate of disease drives up health care costs for everyone — employees, employers, providers, insurers and the government. How effectively can we as health care providers continue to do what we are expected to do unless individuals partner with us to shift the trend?
As an employer, BJC developed tools and resources — including myHealthFolders — for our employees to begin taking steps to take responsibility for understanding how to better manage their own health. As a community benefit organization, we willingly share these same resources with other employers and individuals in the community who also are ready to take charge of their health, available at bjchelpforyourhealth.org.
As a health care community, we are moving from a historically paternalistic philosophy to a shared responsibility that advocates, "Your health is in your hands." Establishing and maintaining personal health records, such as myHealthFolders, can help us move closer to achieving this shared responsibility for personal health management.
STEVEN H. LIPSTEIN IS PRESIDENT AND CHIEF EXECUTIVE OF BJC HEALTHCARE OF ST. LOUIS, ONE OF THE LARGEST U.S. NONPROFIT HEALTH CARE GROUPS.
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