Service lets consumers maintain health records

Access records on Internet 24 hours a day

The struggle to collect comprehensive medical data on new patients may become a thing of the past. A new service, Medical-Record.com, offers a password-secure site on the World Wide Web where individuals can compile, update, and make available their own medical history documents to physicians and emergency care technicians anywhere that Internet access is available.

"People who are using Medical-Record.com come from all walks of life and have a variety of reasons for wanting to manage their own medical record keeping," says Edward Kriese, founder and chief executive officer of San Francisco-based Medical-Record. "In most cases, people want to make their records readily available when they have ailments, allergies, or medication that is critical for a medical technician to know in case of an emergency."

The individual storage site is free, and all records are kept secure through three-way encryption, says Kriese. Physicians and emergency caregivers can access the records 24 hours a day via an encrypted password that is kept on a personal wallet card provided by Medical-Record. (See sample of the card, p. 150.) The password can be changed any time by the individual.

Kriese says that because the site has broad storage capabilities, organizations such as schools, hospitals, clinics, doctor offices, youth organizations, travel clubs, and other businesses also can maintain medical records in groups. Part of the company's service is a complete listing of medical conditions and ailments by category and the latest relative medical advice and treatments.

The idea for the service originated during an overseas' trip. While Kriese was on vacation in Bali, he was able to access his e-mail from the server at the hotel. He knew that if he got injured, though, health care providers there would know nothing about his medical background. If he could access his e-mail, Kriese asks, why not his medical records, too?

"We need portability of medical records and the ability to access them," he says.

The importance of portability increases as consumers become mobile and as managed care environments require consumers to change their health care coverage and providers more frequently.

"When you see a new doctor, you're usually handed a clipboard and told to fill out medical history forms," Kriese says. "If you've been with one provider or managed care system for a long time, you might have a comprehensive data set. But this is not common.

"On average, a typical medical record exists in 12 different places," he continues. "That's a combination of paper-based forms, which are probably accessible to a variety of people and digital formats. Digital formats are heterogeneous in nature but are not compatible with each other and are not accessible by the consumer."

An individual's medical records can be spread throughout a number of locations including physician offices, hospitals, medical clinics, and at home. Forrest Martin, MD, a San Francisco-based primary care physician and chief medical advisor for the company, says that although the individual will have to make an effort to gather documents for the Web service, the benefits of going to the trouble can be invaluable in time of need.

"When people move, travel, or if children need medical assistance when parents are at work, their medical records are not available to physicians when they are most essential," Martin says.

"Medical-Record.com keeps these records secure until they are needed and makes them available at any time and should be made part of any physician's patient services."

The more complete a health information set providers have, the better care the patients receive, Kriese adds. "This [service] gives individuals the opportunity to be proactive about their health."

Gathering the data

To help consumers create their medical histories, the Web site prompts them to answer a series of questions in the following areas:

r personal information;

r employer information;

r emergency contact information;

r insurance information;

r health care providers;

r allergies;

r medical conditions;

r eye care;

r injuries;

r medications;

r immunizations;

r surgeries;

r tests;

r family history;

r vital signs;

r health maintenance;

r health habits.

The company suggests that new members fill out the questionnaire to the best of their knowledge and then consult health care providers, family members, and hospitals and treatment centers for the balance of the information. Many states have laws requiring that patients get access to their medical records.

Records that consumers gather can include forms, X-rays, prescriptions, physicians' notes, surgery documents, or any record of an individual's personal condition that would normally be kept in files.

"Patients are not aware of all of the information that they have access to that is valuable to their physician," Kriese says. "This is the first time we've really made available to individuals a list of everything that the physician is going to want to know from them about their health history."

Once the profile for an individual has been created, it is up to the user to decide whether to share the information with a physician. When the person changes doctors, he or she can print out the information, fax it to the physician, or e-mail it.

Medical-Record has worked to ensure that the information collected is in a form that physicians can use and yet isn't so daunting that the consumer can't provide the information, Kriese says.

The site features a services-based Web architecture that uses a replicated distributed SQL server 6.5 backbone, Microsoft Transaction Server, Internet Information Server, Active Server Pages, Active X components, graphics, and HTML. According to company literature, the lowest common denominator of HTML 2.0 was used to ensure the largest population of on-line users could be reached with subject-specific commercial messages through Web TV, America Online, Windows C, and other consumer delivery systems.

"The application is written so it is respectful of users' [different] bandwidth," Kriese says." Through its worldwide network of servers, the service is also able to house millions of medical records simultaneously.

Medical-Record.com should help consumers feel more confident that health care providers are informed about their medical histories. "It will be a medical [database] they can access and rely on."

Editor's Note: More information on Medical-Record.com is available on the Internet at http://www.medical-record.com.