“Never put the cart before the horse, unless he knows how to push it, of course.” This was the observation of country singer Pat Green in his song ‘Count Your Blessings’. Although Pat is probably not an expert in healthcare information technology (HIT), his comment clearly applies to the effort to drive HIT adoption through the consumer-focused vehicle of personal health records (PHRs).
We have now seen over two years of headlines coming from participants in this field, mostly involving employers, insurers and PHR software vendors, and it has become a media feeding frenzy since Microsoft’s announcement of its Health Vault product in autumn 2007 and Google’s subsequent entry into the market in early 2008. A quick review of the popular press would lead one to believe that millions of Americans are rushing to sign up for these tools and that this pressure will soon force physicians to adopt electronic medical records (EMRs) and thus lead us to HIT nirvana. However, a more careful look at the facts supports a very different conclusion—we really do have the cart before the horse, with predictable results.