If your doctor can read your medical records online, who else can?

RODALE NEWS, EMMAUS, PA—As far as medical health records go, we're kind of trapped in a weird state of transition that can be confusing, frustrating, and even dangerous for patients. Many doctor's officers and hospitals still use traditional paper files, or a mix of paper and electronic files, while fewer than 10 percent have transitioned into the world of electronic health records. But that number is likely to grow sharply over the next three years because of the American Recovery and Reinvestment Act of 2009. The stimulus package provides incentives for physician practices and hospitals to convert to electronic health-record systems that fit government criteria by 2014.

Although it will be very difficult for 100 percent of doctor’s offices and hospitals to go electronic by the administration’s 2014 goal, there’s a good chance at least one of your healthcare providers will. "Electronic health records incentives decrease over time, so the earlier doctors implement them, the more incentive money they earn," says electronic health records expert Paul Tang, MD, an internist and vice president and chief innovation and technology officer for the Palo Alto Medical Foundation in California. "After 2014, there's actually a penalty if you haven't implemented."

THE DETAILS: Currently, some health systems already use electronic health records to pull up patient history and lab results. However, these records don't contain patient information from other healthcare systems or specialists, and other institutions can't access the information. As doctors sign onto the government plan, though, all of your doctors, no matter what hospital or specialist you're seeing, will be able to pull up all of your health information in order to make the most informed decision on your care.

Many of the electronic health-records systems that meet the government criteria will feature an integrated personal health-record component, making it easier for patients themselves to access their records and lab results, and even to communicate with doctors and nurses online. "The integrated version is like a patient's view of their electronic health record," says Dr. Tang. "That probably, in my opinion, has the greatest value to consumers." However, those systems should not be confused with commercially available electronic personal-care records that allow consumers to enter their own information online. Such records aren't protected by privacy laws, Tang warns.

Nadereh Pourat, PhD, associate professor of health services at the UCLA School of Public Health and the director of research planning at the UCLA Center for Health Policy Research, says universal health-record systems could also be a great resource for researchers. "There's a great potential for studying the data at a population level and understanding what needs to be done," she says. "Greater societal benefits could come from electronic health records."