Do-It-Yourself

First I would like to start by apologizing for falling off the map recently. My professional and personal life have been a bit demanding lately, and unfortunately I feel my blog has suffered a bit. Second, given that my schedule is still quite full, I will most definitely continue to post my musings, however I would like to extend an invite to any of my readers who may be interested in doing some guest writing. Feel free to let me know if you have any topic suggestions, or would like to borrow my soap box! Ok, back to the blog...

As I've discussed before, the internet and computers are offering modern medicine a chance to interact with patients in a way that previous generations could only dream about. Recently, I read an article in the New York Times about an innovative new program by Microsoft called Health Vault (http://www.healthvault.com/) that allows consumers to create free personal health records on the web:



"The personal information, Microsoft said, will be stored in a secure, encrypted database. Its privacy controls, the company said, are set entirely by the individual, including what information goes in and who gets to see it. HealthVault searches are conducted anonymously, Microsoft said, and will not be linked to any personal information in a HealthVault personal health record."



Of course, I support any attempt to make the patient more responsible in the maintenance of their health care. Often, it can be difficult for various offices, with different levels of technical know-how and cooperation, to properly coordinate medical care. What a boon it would be to have one resource that everyone could access, and that's controlled by the person-in-question.



The Health Vault site is very simple to use, but while I think it's a good innovation from a leading computer company, I also have some doubts about it. For one thing, it's Microsoft, and even the article notes that it is an attempt by the company to make sure it is the dominant platform used. Could this be a case of something be offered to increase a market share without considering the actual consequences?



Another recent article I came across eloquently discussed the problem of patients not following their prescribed drug regimens:



"On average, half of patients with chronic illnesses like heart disease or asthma skip doses or otherwise mess up their medication, says a report being issued later this week. It calls the problem a national crisis costing billions of dollars."



The article mentions the famous example of former President Bill Clinton going off statins and later needing heart surgery. Apparently, this epidemic of carelessness crosses lines in terms of income and education; no one is immune.



Of course, this is old news to those of who work in medical offices. We know how difficult it is to get patients to properly care for themselves. Sometimes people need a major setback to realize that they are not invincible, or that a problem like high cholesterol is real.



So, naturally, this leads me to wonder if people can't be trusted to take their medicine, how on earth can they be trusted to create and maintain their own medical records? Will they omit information detrimental to, say, their chances at getting insurance? Or something which might embarrass them?



There will always be patients who are scrupulous with their care, and who will be able to build a solid personal database for health professionals to access, but I fear that the vast majority are not up to the task. I say that honestly, and without cynicism. Believe me, nothing would please me more than to see a world where patients were in complete charge of their health. It's just that my professional experience tells me the reality will always be otherwise.



I'm deeply curious about your opinion on this. As fellow medical professionals, what do you think of Microsoft's Health Vault? Should patients be trusted to create and maintain their own health records?