Portability Issues Give PHRs a Rocky Start

Dave deBronkart, a 59-year-old kidney cancer survivor, was intrigued by the ability to read and edit his medical records but nothing prepared him for what he saw in his own Google Health personal health record (PHR). According to a Boston Globe article, the medical records deBronkart transferred from Beth Israel Deaconess Medical Center to Google Health said his cancer had spread to either his brain or spine and listed several other conditions he had, unbeknownst to him. His blood pressure medication also required “immediate attention,” much to his surprise.

In an endeavor to promote PHRs, the Centers for Medicare & Medicaid Services (CMS) launched the Medicare PHR choice pilot on Jan. 13.

Under the pilot, beneficiaries with “Original” Medicare can choose one of four companies—Google Health, HealthTrio, NoMoreClipboard.com, or PassportMD—to maintain their PHR information electronically. A basic PHR may contain data entered by the beneficiary and his or her provider. In this pilot, Medicare will also transfer up to two years of health information from its claims database upon request.

In a CMS press release announcing the Medicare PHR choice pilot launch, former U.S. Department Health and Human Services Secretary Mike Leavitt said, “With up-to-date, accurate and accessible personal health records, Medicare beneficiaries avoid the pitfalls of paper records by having critical information available when they need to make health care decisions.”

Although deBronkart’s experience is one isolated case, it’s enough to create uncertainty about just how accurate PHRs really are.

According to the Globe article, deBronkart was told the discrepancies in his PHR were due to the “clunky diagnostic coding language used for medical billing, or because doctors sometimes label a test with the disease they hope to rule out.”

The eventual transition to ICD-10 may resolve some of the “clunkiness,” but one thing is certain: Physicians and providers can expect an influx of phone calls from patients regarding the content of their medical records.


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10 Responses to “Portability Issues Give PHRs a Rocky Start”

  1. smcohen says:

    I work with an electronic medical record system and the above inaccuracies would not be unusual. Outpatient and doctors office info is often incomplete and inaccurate. Many notes are cut and pasted and only updated with a brief note. Changing to ICD10 the more precise coding system will not solve this problem, as garbage in – garbage out.

  2. Terrie says:

    I think this is this the problem with doing electronic medical records. Paper is so more accurate, less mistakes. Just imagine how many more errors there are. This can affect patient’s bills getting paid accurately.

  3. Sharon Rose says:

    Paper is only good if you can read it!

  4. kpetty says:

    Whether a medical record is electronic or paper if you get bad information it gets passed along the line. Mistakes are a part of human nature.

    It will take some time for the PHR system to have all the idiosyncricies worked out of it. I prefer electronic charting over paper charting…handwriting can be very difficult to read.

  5. Jeannie says:

    I don’t quite understand how information in the patient’s chart that wasn’t relayed to him has to do with a “clunky” coding system. This is not only a coding/billing issue but also on of continunity of the information in the patient’s health record.

  6. Melonie says:

    One must also take into consideration that the patient was told some of this information, when faced with illness or life threatening diseases sometimes you hear the news and your brain focus’ on what you need to do to get you and your family through the ordeal. I’ve witnessed many patients, especially Medicare patients. being given instructions for tests, prescriptions, etc. just to have them call back to the office and have them explained again, or on their follow-up visit will look at the nurse or physician and kindly say “I don’t remember you telling me that”.
    My preference is electronic, there is definitely room for error with both methods, but it causes less eye strain.

  7. sharon says:

    EMR is the way to the future, however, educating the providers and staff on proper documentation and coding needs to be implemented first. I have worked 25 years in the medical field and providers still do not understand proper diagnosing and coding and now alot of the EMR softwares pick the level of service and coding for the providers. There still has to be more checks and balances to the system for myself to be comfortable using. I agree on better it may be better on the eyes and easier to read but we are loosing the thought process on the whole thing.

  8. Tricia says:

    Clunkiness???? First of all I dont see how ICD-10 will solve a problem such as this! The main problem is that if we are going to rely so heavily on billing to compose the medical record of the patient, then we should require providers to have to use certified professionals. As others have said …. “Garbage in…. Garbage out”! I mean really! If they dont know how to code with icd-9 what makes anyone think they will do better with 10 if they are not trained and certified professionals?? I am sorry to rant but I can just see the slippery slope of problems if we use the billing history to comprise such a great part of the patients medical record.

  9. Irma says:

    This is not “clunkiness” this is a “problem.” Unfortunately, ICD-10 will not resolve this “problem.” The biggest obsticle is physicians and medical practices refuse to hire certified coders. The fact is, their focus is on making money and paying a certified coder to accurately code a patients chart, electronic or paper, is not included in their budget. EMR is here to stay, however, accurate EMRs will only be obtainable when practices are willing to invest in certified professionals.

  10. Rgentry says:

    I agree with all the above comments, EMR is nothing compared to paper record. In the EMR there is so much stuff that is not captured due to the click of the hand. When in the patient record time was focused on making sure documentation supported what was being billed.

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