One of my favorite authors is Philip K. Dick. One of the major themes he writes about in his work is what is real, what is reality. He presents situations that make the reader question what they perceive and understand that every person has a subjective point of view that may vary wildly from others viewpoints.

With this in mind I have a short quiz for you:

In regards to personal health records (PHRs) whose viewpoint is the most accurate and complete?

1. The hospital
2. The primary care doctor
3. The specialist
4. The patient

Answers:

1. The hospital has the information from a patient's last visit in the hospital. The care a patient has received after being discharged is not updated in the hospital's system.

2. The primary care doctor receives information from hospital stays, and care other doctors have given to the patient. Usually by fax or mail and generally with some delay. And the information may not be complete.

3. The specialist may not have information from a patient's stay in the hospital unless the specialist ordered the procedure or patient requests that the specialist receives it.

4. ANSWER: The patient is the center of all of these relationships. The patient knows what procedures they have had, what conditions they have, and what medications they are taking. In addition, the patient may not be following the instructions that the physicians have given them including medication dosage directions.

I think that patients believe that all of the health care providers' systems are connected and talking to each other. That is simply not true. This explains why patients are repeatedly asked to fill out the same information on a clipboard each time they interact with a health care provider. This is why the patient has the most complete picture of their health care and can update their personal health record with this picture.