Zweena: Finding the Sweet Spot for PHRs

Shake up the health care system, urges Janet Rae Dupre in her “Unboxed” February 1 New York Times column, “Disruptive Innovation, Applied to Health Care.” She hopes that the country will “innovate its way toward a new health care business model – one that reduces costs yet improves both quality and accessibility.” One way is to create what Princeton University’s Uwe Reinhardt calls a continuum of care that follows patients wherever they go and prevents needless tests and confusion about competing medications.

But even if President Obama follows through on his promise to use technology to improve healthcare and lower its cost, such change is a long way off, I fear. Until then, individual consumers need to figure out how to keep track of their own health records, and the best way I’ve found is to create a web-based Personal Health Record (PHR) through a Princeton-based start-up called Zweena Health (screen shot of home page shown).

PHRs are ideal for a scatterbrain like me, for whom digital everything is a godsend. I keep my calendar and address book on the web, so when I lose my paper copy for the umpteenth time, it’s still there. I get and pay my bills electronically, so when I forget what I paid to whom, it’s right there. Now that my personal health record is available through Zweena, I no longer have to worry about filing my mammogram, blood pressure, and colonoscopy records. When did I have that mammogram? It’s right there.

But I have a more important reason to value Zweena’s service: my husband’s two life-threatening conditions – heart disease (he had a triple bypass) and kidney cancer (he had a kidney removed plus chemotherapy). He’s fine now, but we make a regular circuit of six doctors’ offices and the occasional hospital visit, and he goes to three different hospitals. It’s crucial to his health that the nephrologist knows what the oncologist and cardiologist are doing, and the Zweena service will certainly help that. It could conceivably save his life.

Some object to the potential privacy invasion that PHRs might bring. The privacy of the health record is not that important to me because I don’t need to hide anything from an employer or anybody else. As someone commented on Matthew Holt’s Health Care Blog, “Is our energy truly best directed to worrying about 1) preventing a potential privacy violation or about 2) preventing getting killed or maimed in the health system due to lack of information technology and care providers having the right information at the right time?”

Some PHRs are being kept by insurance companies, some by employers. But I wouldn’t want to have to change services because my insurance changed, or because my job changed, and Zweena clients will own their own records and choose who gets access to them.

Zweena nurses do all the data entry, versus doing it yourself. Nancy Finn (who blogs on Healthcare Basics and was quoted on e-patients.net ) had success with entering her own information in Google’s answer to PHRs. I’m not sure I would be as successful. During the year of my husband’s cancer treatment I managed to keep track of his medical records, but now I’m back to being careless again. If typing in the data were left up to me, I’m might lose the records before I got around to entering them. I would be better off going back to my old system – stuffing everything in a briefcase. At least then I would know where they were. Zweena overcomes the laziness barrier.

I do not anticipate that my carelessness will improve as I age, nor will my health improve, and there may come a time when my children – in the so-called sandwich generation — will need to monitor my medical care. When I did this for my 96 year old mother, I traveled to Baltimore to accompany her to doctor’s appointments. But in the digital age, the doctor could put my daughter on a conference call in her office, and my daughter would have access to that day’s record of the office visit through Zweena.

Full disclosure: As a reporter for U.S. 1 Newspaper I had interviewed John Phelan, who founded Zweena to try to create a workable business and technical model for PHRs. Also a family member has a professional interest in e-health initiatives – but this background has alerted me to what other services are available. I’m eager to hear about alternatives, but so far I haven’t found another service where the service’s professional does the data entry, yet the patient owns the record.

There are oh-so-many other advantages to letting technology creep into the health care system, starting with improved doctor/patient communication, but digital personal health records will really come into their own when all the hospitals go digital. Case in point: my husband just had outpatient surgery at a fine hospital in Philadelphia. As he progressed through the system, seven nurses and doctors asked essentially the same questions seven times, each entered the answers on their own clipboards. In a hospital with digital records, entries could be made just once.

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