Personal Health Records: Directing More Costs and Risks to Consumers?

Abstract:     
This article is principally concerned with a subset of electronic health records known as personal health records. In contrast to the more familiar charts, paper records, and electronic medical records maintained by health care providers, personal health records are medical records created and maintained by patients. A personal health records model is superficially attractive because it seems to lack the "misaligned incentives," network effects, and other market failure problems associated with the financing of a national inter-operative EHR model, while the model's patient-centricity purportedly avoids the privacy-confidentiality-security externalities inherent in electronic health records. The principal thrust of this article is that personal health records are dangerously flawed adjuncts to or substitutes for provider-centric records, and while lacking many of the touted quality or cost-reduction benefits of oft-criticized electronic health records they pose substantially higher levels of risk regarding security, privacy, and confidentiality. The conclusion is that, as with their technically more complex electronic health records sibling, personal health records require a fundamental re-working of the legal model applicable to all electronic health records.

Number of Pages in PDF File: 46

working papers series