Why Your Medical File Belongs Online

PersonalMD.com and its competitors are building businesses on the idea that some online information could save your life.

By Todd Woody, The Industry Standard

It's 2 a.m. and paramedics rush an unconscious man to an emergency room. Little is known about the patient, and his medical records are not available until the start of the business day, so a doctor runs a battery of expensive and time-consuming tests.

But another scene may soon unfold. This time, paramedics reach the patient who is carrying a medical-alert card emblazoned with a Web address. They radio the information to the hospital, where a nurse logs onto a Web site containing the patient's medical records. By the time the ambulance arrives at the ER, a doctor has reviewed the patient's medical history and charted a course of possible treatment.

That's the vision PersonalMD.com, a Pleasanton, Calif.-based startup that launched an online medical-records service last month, is promoting. The company hopes to persuade doctors and patients to replace paper charts with digital files that can be accessed anytime, anywhere.

Drkoop.com will offer a similar service later this year. And offline medical software company MedicaLogic has recruited a coterie of Netscape veterans to move its electronic medical-record product for physicians to the Net this fall. A separate service for consumers will let patients review their medical records online. And a Seattle company, Elixis, plans to offer online medical records later this year.

Whether the average person will put sensitive personal information on the Web remains to be seen. But if successful, online medical records could rapidly change the doctor-patient relationship. It is increasingly common for patients to tap the same online databases as doctors when researching medical treatment. Soon physicians may be asked to share information patients have a right to review but in practice rarely request.

"From a doctor's standpoint, we have to recognize that some of the folks who did not grow up in the Internet world will not immediately embrace this," says MedicaLogic's Cameron Lewis.

Notes PersonalMD CEO Suresh Challa: "Clearly there's a fundamental shift in the doctor-patient relationship. The patient is becoming a consumer, and the doctor is becoming a service provider."

Online medical records could potentially improve the quality of health care and cut its cost by giving doctors and their staff instant patient information. "Access to medical records in the middle of the night from institutions all over the globe would be very, very helpful," says Dr. Scott Plantz, VP of the American Academy of Emergency Medicine's board of directors. "As a practicing emergency-room physician, I can't tell you how many times at 3 a.m. access to an EKG or access to a discharge summary from a patient's last hospitalization would have saved me a lot of testing."

First out of the gate, PersonalMD is a spin-off from health-care consulting firm NeoTrax. The new company is relying primarily on patients themselves to obtain medical records from physicians and post them on the Net. Once people acquire medical records, they fax them to PersonalMD, which converts the documents into a digital format. Similarly, emergency-room doctors and other physicians without Net access can obtain the records by fax.

DrKoop.com also will depend on patients' and doctors' cooperation to put medical records online. The Austin, Texas-based startup has two significant advantages, though: its association with the former surgeon general and a deal with America Online that will make its personal medical records available to some 19 million AOL (AOL) members.

However, the company to beat may be MedicaLogic. The Hillsboro, Ore.-based company says it has secured more than $100 million in funding from such investors as global financier George Soros and Sequoia Capital.

MedicaLogic's software, used by about 7,000 health-care providers, has created some 7 million patient records, says company executive Lewis. When doctors put medical records online, they will be available to patients at MedicaLogic's consumer site.

"When you look at this in a rearview mirror in a few years, you'll see that it's really a watershed time," Lewis says.

"People are beginning to take more control and have more choice about the way their medical information and health information is used."

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