Medicare launches personal health records for South Carolina residents

Washington -- Medicare has started a yearlong pilot project in South Carolina testing online personal health records as a way to enable beneficiaries to get more involved in their care and better manage their conditions.

Patients control their records and decide who has access to them -- from doctors to family members. Users need an ID and password. Physicians could add information to the PHR, but patients could remove it.

Although the records are geared toward patients, they are useful for doctors. They give physicians baseline information on a person's medical history, said Lorraine Doo, senior policy adviser with the Centers for Medicare & Medicaid Services' Office of E-Health Standards and Services. "It is a good starter but not a replacement for a good intake interview."

Medicare claims information will be entered into the PHR automatically once the patient registers with the project and requests the data. Individuals are able to add information not found on Medicare claims. This could include notes, advanced directives, out-of-pocket expenses and prescription drug information.

PHRs provide links to Web sites with educational materials on health topics to make it easier for beneficiaries to research their conditions.

The records will be helpful to doctors when patients seek medical care out of state and can't remember what procedures they received, said Gerald E. Harmon, MD, immediate past president of the South Carolina Medical Assn. Because the records are on the Internet, physicians will be able to access a patient's medical data from multiple locations, he added.

Dr. Harmon, a Pawleys Island, S.C., family physician, said the association is supportive of the project. He is interested in entering prescription drug data into his patients' PHRs, he said.

But the accuracy of the information in PHRs is not as high as physicians would prefer, Dr. Harmon said. He noted, though, that the Medicare data will contain reliable information on diagnoses and procedures.

A 2005 study on PHRs published by the American Medical Informatics Assn. found that patient-supplied information was not as accurate as more comprehensive data exchanged between physicians, but it was still useful.

PHRs promote communication between physicians and patients, said Debra Roter, DrPh, a professor at Johns Hopkins Bloomberg School of Public Health.

They also could reduce medical liability suits, said Roter, a researcher whose primary focus has been on physician-patient communication. "Lots of studies support that patients feeling well-informed are less likely to sue their doctors."

Despite its potential, few people will use the program, predicted Stephen Downs, deputy director of the Robert Wood Johnson Foundation's Health Group. Many patients can access a PHR through their insurance companies, but only a tiny fraction do, he said.

The pilot program, which is called MyPHRSC, is limited to fee-for-service Medicare beneficiaries. The system will not import data from existing electronic medical records, Doo said. Prescription drug data will not enter into the system automatically even for individuals in a Part D drug plan.

The PHR tool selected for the project is by HealthTrio, a Centennial, Colo., company that offers a number of electronic health products and services. The pilot began in April and is managed by QSSI, a health information technology firm in Gaithersburg, Md.