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The Personal Health Record -- a Proactive Resource for Reducing Healthcare Expenses

Utilizing a personal health record can decrease healthcare expenses because many of the dollars spent in healthcare go toward the generation of information necessary to diagnose and appropriately treat. With passage of the Patient Protection and Affordable Care Act, which will expand healthcare coverage to an additional 32 million persons by 2019, more patients will be establishing new doctor/patient relationships and the flow of health information will most likely increase exponentially.

Although in recent years there has been a push for doctors to purchase and utilize electronic healthcare record programs for management of patient health data in the hopes that there will be a centralized database of patient health information that will minimize treatment errors, in actuality, most doctors have not adopted the technology, and even if most did, because of the differences in practice and recording styles, a central database would not contain all of the data updated in real-time to meet healthcare needs of every patient in every healthcare setting and situation. Therefore, the best repository of health information is you and your own personal health record.

One scenario illustrating the cost of generating and exchanging health information is the initial new patient visit to establish a doctor/patient relationship. A physician or other healthcare provider evaluating a patient for the first time needs information provided by the patient which is oftentimes lacking because the patient is not knowledgeable and/or because previous treatment records were not requested, requested but not received, or requested and received but illegible. The new physician will oftentimes need approximate dates of diagnoses, approximate dates and results of prior tests, and approximate dates of hospitalizations with some details of the care which was given. If that information is not available, some doctors will order tests that he or she might otherwise not order had the necessary information been available at the time of the patient visit. The net result is an increased expense for the patient or at the very least another component of healthcare inflation.

Many diagnoses and treatment plans are made based on subjective information, i.e. information communicated by the patient. For example, in evaluating chest pain a doctor will usually need to know when and how the pain started, the location of the pain, the frequency of the pain, the duration of the pain, the intensity of the pain, the quality of the pain (cramping, burning, stinging, etc.), what makes it better, what brings it on, what makes it worse, and other symptoms associated with the pain before deciding whether to admit the patient to the hospital to rule out a heart attack or whether to treat the patient for acid reflux outside of the hospital. Oftentimes however, because of poor preparedness and/or because of nervousness, patients feel put on the spot when asked certain questions about their symptoms and conditions. By recording information pertaining to symptoms and conditions to be discussed during a future visit to the doctor, a patient is better prepared for the visit with useful information which can reduce expenses by minimizing over-reliance on the ordering of tests. Additionally, the information is more likely to be accurate and thus more likely to maximize the quality of healthcare received.

A personal health record might therefore also lower healthcare costs during follow-up or sick visits because a well-designed personal health record software program enables the patient to create journal entries and pre-visit notes about new and established problems, which can be printed and carried to the doctor at the time of a visit. Additionally, by updating entries in the personal health record the patient tends to be even better prepared to answer questions that will be presented during an upcoming visit to the doctor.

The length of the average doctor visit in the United States today at the time of this writing is approximately 16 minutes which is fairly generous compared to a county like Holland where it is 8 minutes. Factors which are likely to result in a decrease in the length of doctor visits in the United States include healthcare reform which will increase the number of patients receiving treatment, the shortage of physicians, and increasing medical practice overhead. If the average duration of a visit to the doctor in the United States does shorten the number of visits to address a set number of conditions more than likely will increase unless more can be accomplished per individual visit.

Implementing and maintaining a personal health record in principle should reduce healthcare expenses not only at the time of the new patient visit, but also during established patient visits by shifting the diagnostic emphasis from objective date to subjective data and reducing the number of required visits. Containing healthcare costs by the utilization of a personal health record is predicated on the principle of more efficient generation and exchange of accurate health information.

Disclaimer: This article is for informational purpose only and is not intended to serve as a substitute for medical consultation with a qualified professional. The author encourages users of the Internet to be careful when using medical information obtained from the Internet and to consult your healthcare professional if you are unsure about your medical condition.

by Victor E. Battles, M.D. - April 17, 2010

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Having more than 20 years experience treating and evaluating patients I fully appreciate the value of accurate patient health information and its contribution to quality healthcare and cost containment. Learn how to organize your personal health information and how to optimize health information exchange with a personal health record by visiting my website.  




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