Building A Child's Personal Health Record
By Lynanne Lasota
Because much of the accuracy of a diagnosis relies on a medical and health history, parents can partner with their child's health providers by creating and keeping a PHR up to date.
"Be careful!" Mom often yells toward the door as the children run outside to play. The warning urged so often in the past may not pierce the ears of the excited children, but Mom means it.
Unfortunately, Donna Macia was not at home to remind her daughters to be careful when, accompanied by their 5-year-old brother, Cisito, they crossed a busy street to greet their father, Ciso. Cisito, suddenly alone, stood motionless in the road. "In the rush one of the girls dropped his hand," said Donna, in recounting the horrible moment when a van hit the boy, knocked him into the air, and then hit him again.
When paramedics arrived by helicopter, Ciso and the sisters answered questions about Cisito's health history and recent medications as best they could. It would have been much easier for them if Mrs. Macia had been home, because all the information they needed was on a piece of paper that Donna kept in her purse.
Cisito, who miraculously survived with only scrapes on his hands and legs, was a non-medicated, non-allergic, healthy child, so such conditions didn't factor into decisions on his treatment. However, that's not the case for every child.
"We are a much more medicated society than 30 years ago," said Jill Burrington-Brown, practice resource manager at American Health Information Management Association (AHIMA). "The medical professional can't assume a child is not on medication." If a medical professional doesn't know current and recent medications, the treatment used could cause more problems.
Marie Savard, M.D., internist, women's health expert, and champion for patient rights, explained that 80 percent of the accuracy of a diagnosis relies on the medical history, or personal health record (PHR). Dr. Savard recommends creating and keeping a PHR up to date for each child. Ideally, every member of the family should have a current PHR. Here are various elements to put one together:
Tools to organize a lifelong health record.
A three-ring binder or folder for each child. "Then I know everything related to that child is in one place," said Dr. Savard. When the child grows up, he can take it with him.
An online PHR form. Use a form like Health at a Glance (www.mercksource.com) or a similar chart. This will give a medical professional the initial information needed to treat a patient properly. The form has spaces for personal information, allergies, medications, chronic conditions, and past illnesses. The form "is the snapshot of everything," said Dr. Savard, and every person should carry a copy of his with him at all times.
Entering all the data on a single form may seem daunting, especially if the family health records are currently stuffed into a file folder or are hard to find. "A good place to start is by printing out a hard copy of the forms," said Jill Burrington-Brown, (www.myPHR.com). Burrington-Brown recommends filling out what you can now and later adding data that you remember or locate.
Next, print and fill out the Family Medical History Tree form (available at www.mercksource.com/ppdocs/us/cns/content/savard/forms/family_med_hist_tree.pdf) one time, photocopy it, and place a photocopy in each child's PHR. "Parents need to know what runs in the family," said Dr. Savard. This helps the medical professional know what to do and points to which tests to run.
PHRs of the future...today.
Eagle Scout Jason Best, now vice president of marketing with iHealthRecord (www.ihealthrecord.org), agrees that a folder with a person's paper PHR helps keep data organized. He believes an online version that can be accessed and printed out provides additional benefits. "You have the ability to have your PHR anywhere, anytime," said Best.
Patients can prepare a free, secure online PHR at this Web site. Physicians who are members of iHealthRecord keep patients' medical records confidentially online.
"It's fully transportable," said Best. Patients can access the information from any computer with an Internet connection.
Partnering with your child's health-care provider.
Once all the information remembered is placed on the forms, additional data about the child's health can be acquired from medical professionals visited in the past. While all records may not be needed, you may ask for copies of those that are. Check with the administrative staff of each professional for his record-copying policies, fees, and schedules.
From the outset, tell a doctor you want to partner with your child's health-care providers, said Dr. Savard. "Have each doctor fill out your form so you have a comprehensive copy." Immediately add the form to the binder or type it into the online PHR.
Diagnosing your child's symptoms.
Partnering with a child's health-care provider includes researching the cause of a child's symptoms. With all the Web sites available, it can be difficult to know which medical information is true and accurate. "Make sure the content is reviewed by an independent advisory board," said Maggie Kohn, director of corporate responsibility communication for Merck & Co., Inc. Merck, Kohn said, has been providing unbiased health information free as a public service since 1899. She pointed out that Merck keeps a firewall between the product side and health issue side.
Jill Burrington-Brown strongly encourages keeping the PHR up to date because the human memory is not perfect. "It's almost a legacy [to keep a PHR for someone] because there is so much we can do for prevention," she said.
Freelance writer Lynanne Lasota lives in Queen Creek, Ariz.
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