I hate to keep bashing Silicon Valley, since I’ve come to think that it’s venture capitalists, not tied to one particular region, who are the ones not “getting” healthcare. That said, we got a bit more overblown hyperbole coming out of Northern California this morning from drchrono.

The Mountain View, Calif.-based company, which likely is correct when it says it created the first EHR that it native to the iPad—and a free one at that—announced today that it has received an new round of $650,000 in seed funding  from the VC community. (Congratulations on that.) Drchrono today also introduced OnPatient, an iPad app that replaces the hated clipboard and paper form for taking patient history at the doctor’s office. Here are the details, from the drchrono press release:

drchrono Launches iPad App to Replace Paper-Based Check-In at Doctor’s Office; Closes Additional $650,000 in Seed Funding

Free OnPatient App Digitizes Patient Waiting Room and Integrates Seamlessly with Electronic Medical Records

Mountain View, CA – August 18, 2011 – drchrono, the company modernizing healthcare through a free Electronic Health Record (EHR) platform on the iPad, today announced a new patient check-in app which replaces the traditional paper check-in process in the physician waiting room. OnPatient is an app that can be downloaded to the iPad for free and integrated into a medical practice as a stand alone onboard app. The patient check-in app also seamlessly integrates with drchrono’s Meaningful Use-certified iPad EHR.

On the heels of the OnPatient product launch, drchrono recently closed an additional $650,000 in seed funding from prominent start-up investor Yuri Milner, founder of DST Global, and venture capital firm General Catalyst. This follows $675,000 in seed funding from General Catalyst, Charles River Ventures, 500 Startups and angel investors, previously announced in July.

“The OnPatient check-in app digitizes the waiting room and eliminates significant barriers to mass adoption of patient check-in technology by leveraging sophisticated iPad technology. Proprietary check-in hardware is prohibitively expensive and integration with existing EHR systems is too complex,” said Michael Nusimow, co-founder and CEO of drchrono. “We designed the OnPatient app to be intuitive for both physicians and patient users to create a better patient check-in experience.”

OnPatient is a full-featured app with customizable templates that enable physicians to eliminate paper forms and clipboards in the waiting room. There are no contracts or monthly fees; the only hardware investment is the iPad itself. Upon download, the OnPatient app allows patients to:

• Complete family medical history and demographic information
• Complete insurance information
• Snap a profile photo
• Sign the HIPAA consent form with a digital signature

The touch screen interface is user-friendly and the information auto-populates directly into the drchrono EHR platform. On subsequent visits, patients do not have to complete duplicate forms—they need only review their information and make any necessary changes on the iPad. OnPatient meets all industry security standards, ensuring the privacy and safety of patient data.

For more information on drchrono and the OnPatient app, please visit www.drchrono.com.

About drchrono: 

drchrono focuses on Apple’s iPad and cloud computing to build a better healthcare experience.

They offer a free EHR platform built on the iPad that is Meaningful Use certified.  drchrono is also the first iPad EHR to implement real time clinical speech-to-text. drchrono handles everything a doctor needs to run their practice, including medical records, electronic prescribing, medical billing, and patient management.  For more information, visit https://drchrono.com

The drchrono iPad EHR is 2011/2012 compliant and has been certified by InfoGard Laboratories, an ONC-ATCB, as a complete EHR in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments. drchrono version 9.0 was Stage 1 certified on June 3, 2011. The ONC certification ID number is IG-2492-11-0083

 

What got me was the claim in the e-mail that accompanied the press release. “Today, drchrono, a hot Y Combinator start-up focused on Apple’s iPad and cloud computing to build a better healthcare experience, announced OnPatient, a groundbreaking app that digitizes the medical practice waiting room,” the message started. This was the same claim that drchrono included in a media advisory earlier in the week.

Sorry, there is nothing “groundbreaking” about software that collects medical history electronically and automatically populates an EHR with this information. Instant Medical History, a program from Primetime Medical Software, Columbia, S.C., has been doing this for years. Though it is primarily a PHR vendor, NoMoreClipboard.com‘s name betrays one of its products, a patient portal for medical practices that collects patient history online. ePatientHistory.com is similar.

No, IMH does not have a native iPad app, but it’s worked on tablets going back to the bulky Windows tablets circa 2003, even if few customers actually chose that option. NoMoreClipboard.com is Web-based, which means it’s accessible from any device with a Web browser such as, say, an iPad.

When I called the publicist on the “groundbreaking” claim, I got this back. “Of the physicians I’ve spoken to, the user-friendly interface of the iPad app really makes patient onboarding easy and they love the ‘novelty factor’ of using the iPad as well. It’s less intimidating for patients who have limited experience with healthcare IT.”

Fair enough. But that doesn’t make OnPatient “groundbreaking.” The iPad is groundbreaking. OnPatient is interesting, useful and frankly, long-overdue competition to Instant Medical History. I hope it catches on. But it’s not much of a breakthrough.

I can’t wait to see the breathless coverage from the other tech press who don’t know the, ahem, history (sorry, couldn’t resist). If you want the unvarnished, occasionally acidic truth, come here.

For that matter, here’s the company’s own message, via video:

It’s rather low-key, actually. I have just one question: Why do they say “tax breaks” for meaningful use? The money is in the form of Medicare/Medicaid bonus payments. As EMR and HIPAA readers know, those payments are considered taxable income. Just sayin’.

Patient Doctor Relationship
It seems like this topic keeps coming up in my online and social media reading. Basically, the discussion usually centers around the role the patient plays in healthcare. Many people like to discuss what has been called the ePatient. I instead want to talk about the motivations of patients and their ability to influence the healthcare system.

Patients in healthcare are unlike “customers” in many other industries. I can’t think of a single patient that wants to go and see a doctor. Ok, maybe they like the doctor and they want to get whatever’s ailing them fixed, but to a person I’m sure we’d say that going to the doctor is the last place we want to be. It’s not like going shopping for a new pair of shoes. There’s nothing you get to take home from the doctor. Well, at least nothing that you really want to take home.

Plus, healthcare is an interesting thing, because often it’s not clear if you should go to the doctor or not. If my A/C is broken, then it’s quite clear that I need to call an A/C repairman. Seeing a doctor is quite different since it’s a fine line between when you need to go and see the doctor versus when your body will heal on its own. I think we’ve all hated the doctor visit where they check you out and basically say there’s nothing they can do for you. Well, other than send you the bill for your visit. I guess that’s the cost of the peace of mind that you get from the visit (I know I’ve done that with my kids a few times).

Please don’t take this as me knocking doctors or the healthcare profession. They provide an absolutely essential and critical role in our lives. Without great doctors many of us wouldn’t be here today. My point in this post is that the patient doctor relationship is quite different than the customer business relationship that we’re use to seeing.

Online Patient Portals
Take for example the online patient portal. Many people love to go on Amazon.com (or insert your preferred shopping site) and browse through all the various things they could buy. We all know people who spend hours shopping. I don’t think I’ve ever heard someone say that they wanted to spend hours browsing through their patient portal. You know, someone who just couldn’t wait to see what great healthcare services their doctor could provide them.

The only partial exception to the above reasoning is possibly the chronic patient. If I’m a diabetic patient, then I am going to have an ongoing dialogue with my care provider and the services they provide. I’m going to be interested in monitoring and tracking my care in collaboration with the treatments that my doctor provides.

Is there a reason why we don’t want this kind of interaction for our general healthcare?

Regular Online Interaction with Doctors
Why shouldn’t I go online on a regular basis so that my doctor can assist me in total wellness even when I’m a healthy patient? The difference here of course lies in doctors treating symptoms and illness as opposed to a very different form of care: wellness. To be honest, I’m not sure I’ve seen any doctors who treat healthy patients. Sure, some doctors do provide some pro-active wellness information during a sick visit to the doctor. Regular physicals are the closest we come to doctors treating healthy patients, but how many health people get those? It feels counter intuitive that we would go and see a doctor when we’re healthy or appear to be healthy. However, maybe that’s the shift our healthcare system needs.

Reimbursement Model Challenge
One real challenge with what I just described is the reimbursement model we have in healthcare. We’ve incentivized treatment of sickness and illness. We haven’t (yet?) incentivized treatment of healthy patients and promotion of wellness. This sounds a bit like the ACO discussion that’s become so popular these days. I’ll be interested to see how these incentives play out. Word on the street is the train has left the building and reimbursement is going to be tied to healthcare outcomes in the future.

Healthy Patient Motivation
Unfortunately, another major challenge I see is that healthy patients aren’t really motivated by wellness initiatives. I’m sure that there are people that understand this phenomenon a lot better than I. Although, I think it’s abundantly illustrated when you talk to someone who’s getting older and starting to lose their health.

It seems particularly poignant for highly successful people that start to get older. How many times have we heard during Oprah or a Barbara Walters interview someone talk about being willing to give up all their riches and fame to just have their health (and they often throw family in there too)? All the time! The problem is that it takes old age or some other health incident for people to make healthy living and wellness an important part of their life. Which begs the question of whether even a change in the reimbursement model for healthcare will get unmotivated people to visit their doctors and be “treated” even when they’re a healthy patient.

Gamification of Healthcare
One idea that I find incredibly intriguing is the idea of gamification of healthcare and wellness. The basic concept behind gamification is to create incentives for people to do the behaviors you want them to do. I believe Foursquare was one of the first applications to do this. They would give you electronic badges and crown you as mayor as you did certain things on their mobile app. It was (and still is) amazing to see what people will do for a little electronic badge and the electronic title of mayor (Turns out this works in the offline world as well. There’s a reason boy scouts give out badges, beads and pins.). The question is how can we apply rewards systems to incentivize healthy behavior and wellness?

To be completely honest, I don’t think I’ve seen anyone crack the gamification code in healthcare. Although, I think the concept is just beginning. I predict in the next couple years that we’re going to see some amazing mobile and web applications that really drastically impact our motivation to healthy living.

The closest I’ve seen so far has been something like the Nike+ device and website. It’s a simple device that tracks your running habits either in a watch, iPod or even in your shoe. Then, that device uploads your running data to a website where you can create and track your running progress. It also provides a social experience, but that’s a topic for another day.

I actually find these tracking device/website combinations (see the FitBit and DigiFit as other examples) to be some of the most interesting things happening when it comes to pro active treating of healthy patients. A while back I predicted a whole plethora of medical tracking devices are going to hit the market. This is happening and will continue for many years to come. I heard one guy interviewed who talked about one day (many years from now) having little mini processors attached to every nerve or blood cell in our body. Ok, that’s kind of creepy to think about, but personal monitoring of our body is a burgeoning field in healthcare.

Crunching All the Personal Healthcare Device Data
The question once we’re monitoring all of these various vital signs and health information is what are we going to do with that information. Is it reasonable to think that we’ll be able to use computers to crunch through all the data and provide a self service analysis of all the data collected? Yes, Watson did some amazing things on Jeopardy, but I think we’re far away from the day when this type of self service crunching of all the medical data we collect will be possible.

Yes, that means we’re still going to need doctors and other healthcare professionals who help us analyze the data that we’re collecting and dealing with the health issues that are related to that data. In fact, I predict a whole new breed of doctor will come together that will be specialized at analyzing this data and treating even the healthy patients.

Future Healthy Patient Doctor Relationship
This all comes full circle when you go back to the start of this discussion: the doctor patient relationship. How are doctors going to see all this health information we’re collecting? Where are we going to have these healthy patient interactions with doctors? I predict that it will be through patient portals that are connected to a physician’s EHR.

I and every blogger I’ve ever known has been a stats junkie. We’re addicted to checking our stats. There’s no reason we wouldn’t be just as addicted to checking our health stats on a patient portal. The problem is that the patient portals I’ve seen aren’t there yet. Plus, most doctors aren’t yet ready for this type of healthy patient interaction around such a large set of data. Although, I predict we’ll get there and it will change the doctor patient relationship forever.

I was looking through the HIMSS session titles and saw one about the Usability of PHR, which prompted me sending out the following tweet:

Usability of PHR? First, shouldn’t we address the reason to use PHR?

January 14, 2011 12:53 pm via webReplyRetweetFavorite

@techguy

John Lynn

Then, a smart HIT journalist named Neil Versel sent his comment on my tweet:

Amen! #healthit #PHR RT @techguy: Usability of PHR? First, shouldn’t we address the reason to use PHR?

January 14, 2011 1:55 pm via ÜberSocialOrigReplyRetweetFavorite

@nversel

Neil Versel

Something to think about this weekend.

In kind of ironic timing, the news was recently reported of a patient talking to lawyers about a possible lawsuit against a doctor who sent her protected health information (PHI) to his home email in an un-encrypted format. The irony is that for the past week, my post on Email not being HIPAA secure has been having a really good discussion happening in the comments about these very issues (you should go read through the comments, they’re very interesting).

One interesting part of the above news story is that it didn’t even include the most common personal information used for identity theft. Certainly a person’s name and medical information should be kept private as well and could have consequences related to its release on the internet. However, it definitely doesn’t bring out the privacy critics like a breach of financial related info would bring.

While I personally hate lawsuits, a part of me kind of hopes that this or some other lawsuit happens related to email and PHI. Not because I like lawsuits or I want someone to be held responsible. Mostly because we could use some legal precedent to better enable those who want to use technology like email. Until the precedence is set (or a more specific law), I think that many people are just too afraid to use email for any sort of health care related communication.

In the comments I mentioned above, someone even commented about them wanting a doctor who would let them waive their right to privacy in the name of convenience. Basically, they would rather use email to communicate even PHI at the risk of someone seeing their health information so that they can use communication tools like email in their healthcare. I bet there are a lot more people who would opt in for this also. The problem is that the law is such that I don’t know many doctors who are willing to take the risk even if the patient gives them permission.

The best alternative right now is the patient portal where a patient receives an email saying something has been added or updated on the portal and invites them to login to the private secured portal to see the PHI or other health information. Not perfect and not that broadly adopted.

Lots of other issues related to email with doctors, but at least resolving the privacy and security ones would allow us to focus on those other issues.

Bobby Gladd recently pointed out this interesting YouTube video of Dr. Joseph Kvedar speaking at the 2010 Connected Health Symposium. In the video Dr. Kvedar makes some interesting observations about humans and their relationships with devices and how that applies in healthcare. He calls it emotional automation. Check out the video if you have a few minutes.

I find this concept really intriguing. At a very practical level (since my heart is very practical), I couldn’t help but draw the parallel from what Joseph Kvedar said and the idea of the online doctor’s visit. There’s so many reasons that this should be successful and so many situations where an in person visit doesn’t matter.

I’ll share a quick personal experience. Being around doctors and working with doctors as much as I do, I’ve had occasion where I was feeling sick and didn’t have the time to go and see my regular doctor. In one instance, I was leaving for Hawaii the next morning and it was 4 PM the day before. Basically, no time to get to my doctor.

As it so happened, I was in the office of a doctor that I worked with. I mentioned the issue and told him my symptoms. He then asked if I wanted him to write me a script. I was a bit taken a back by the request. I certainly wanted his help, but shouldn’t we have gone in and done the routine. You know the routine. The one where the doctor listens to your breathing and heart (or whatever they’re really listening to). Feels around your neck. Looks in your mouth and ears.

Instead, this doctor went straight to the script. Turns out I’ve since learned that in many cases that doctor routine just isn’t really needed. In fact, many times it’s just done for the sake of the patient and not part of the diagnosis at all. Oh the dirty little secrets of healthcare. If you’re a doctor you already know all about this I’m sure. And certainly I’m not advocating removing the patient visit all together. Just in many cases it’s just not needed.

Of course, my point isn’t necessarily advocating a certain treatment method of not. I’m not a doctor and I don’t claim to be. I’m just sharing what I’ve heard other doctors say. What I am suggesting is that for this change to happen, there’s going to have to be a change of mentality by the patient as much as the doctor.

Dr. Kvedar describes well in the video above that we’re capable of relationships with technology. We can change our behavior and adapt to these types of changes. It will just need the right amount of education and technology to make it happen. I know some EMR vendors have patient portals, but I haven’t seen many that have dove in head first to the online visit model. Probably because the reimbursement model for online visits is still lagging behind.

Lots of really interesting things to chew on in this discussion. I’ve really just begun the conversation. I have a feeling the comments on this post are going to be intense.

I recently sat down with Jeff Donnell from NoMoreClipboard. We had a fascinating all around conversation, but one of the most fascinating things he told me was the story of his last visit to his doctor’s office. I’ll do my best to recount what he told me.

When he decided he needed to go see the doctor for a visit his wife suggested that he call the doctor to make an appointment. Of course, Jeff “eats his own dog food” and decided that instead of calling for an appointment, he’d request an appointment through NoMoreClipboard. So, he logged into his account and sent off the request for an appointment with his PHR attached. Pretty interesting idea no?

Don’t ask me why, but when possible I’d much rather request something through my computer. Maybe it’s sitting on hold while you wait to talk to someone that’s turned me off to the phone call, but the idea that I could request an appointment online even if the doctor isn’t on NoMoreClipboard is a pretty attractive feature for a PHR.

Of course, since Jeff’s doctor wasn’t on NoMoreClipboard, his appointment request and health record were faxed to his doctor’s office. He got a call from the doctor and scheduled his appointment. The story certainly doesn’t end there.

When he arrived at the doctor’s office he wondered if they’d have his record or not. They handed him the standard clipboard to fill out all the paperwork. He still said nothing and dutifully filled out the paperwork. No one said anything about the record he’d sent until he was with the doctor and the doctor realized that Jeff was the one that sent in his PHR. I guess it was the talk of the office when that fax came in.

Obviously, the idea of requesting an appointment and faxing in your health record using a PHR still has a ways to go. In fact, NoMoreClipboard’s goal is to work with doctor’s offices like these so that the office gets the person’s health record on the forms that the doctor’s are use to getting it on. I think that’s a smart strategy. Not to mention the idea of the patients driving their doctors to use and work with a PHR provider. I think they call that Word of Mouth advertising right?

I’ve been thinking about this for a while when I recently talked with someone from Microsoft’s HealthVault division. I quite frankly asked this gentleman why I should use a PHR. Obviously, if I was a patient with a chronic or complicated illness I could see a compelling use case. However, what’s the use case that will drive and motivate healthy individuals to use a PHR. So far I really haven’t heard a good answer.

Requesting an appointment and not having to fill out that same lengthy cumbersome paperwork is the closest I’ve thought of.

Many of you know I’m all about keeping things simple, effective and useful. It’s better to have something simple that does a killer job at what it does than to have something so complex that no one uses it. In fact, that’s really the basis of my simple plan for meaningful use. Of course, this can often be confused as not valuing other items. However, that’s just not the case. You just start with reasonable goals and do amazing things with it. Then, you expand once you’ve conquered something simple, but I digress. The point is that I really enjoy seeing simple systems that just flat out work.

That’s why I was intrigued by an email I received from a reader about their system called ePatientHistory. I think it can best be described as a simple patient portal that tries to do 2 things really well: online patient registration and online patient payments.

I should make a disclaimer that I haven’t used this service other than the demos on their website. However, I really like some of the concepts and I wish more EMR companies would try to create something simple and effective that focus on small goals as opposed to trying to cure the whole world with a patient portal that is so complex no one uses it (man I’m in a ranting mood today). Let’s talk about each function which they call ePatientHistory and ePatientPayments.

ePatientHistory – Online Patient Registration
I tested the demo for this and it was a little buggy and not as intuitive as I would have liked it to be. For example, it didn’t have the standard * next to all the required fields and the pop up that was shown for the required fields didn’t make much since to me. A small thing that makes a big difference. Maybe this just wasn’t shown in the demo, but it would have been nice to had nested questions that were only shown if I’m female for example. That way I can skip the pap smear questions and go straight to the testicular self exam ones.

Also, it was awkward to have to register and then choose the form I want to fill out. Ideally the doctors office could just send me an email that has basically registered me into the system. The email would include a link which I click and get taken to a step by step webpage of what the doctor’s office wants me to do for my appointment. Then, I can’t screw it up as a patient. After I’ve filled out the important paperwork, then let me see the full login and the other features that I may want to use.

Of course, when you’re dealing with a standalone portal like this, the question really is how are you going to get the information out of the system. This system seems to offer a CSV file which can then be imported into an EMR. Ideally, I’d like this company to show me a list of EMR companies that support this type of import. I know that all of them could since CSV is pretty standard, but how many would and if they do would that data be inserted into your EMR in a useful way? Of course, many might just want the health history form to be a nice PDF file that they can upload to their EMR. However, it’s just sad to lose all that data in a PDF file.

The cost structure for this service is interesting. Basically it’s $695 up front and $39.95 per month for hosting. Seems a little pricey to me, but if they can make sales that’s a really good business model to have. You get the up front money and a residual income.

ePatientPayments – Online Patient Payment
This is an interesting module since it’s basic idea is to collect payments. Although, one good part of this system is that it will collect payments over time according to a payment plan. I think this can be really useful in collecting harder to collect accounts. Plus, it can be scheduled to be done automatically thanks to the power of Paypal.

Similar to the other description above, I’m not sure how the patient will know how much to pay. I didn’t see anywhere in the admin that seemed like a place that someone in a clinic could notify someone that they have a bill to pay and come to this portal to pay it. That would be nice functionality. Although, it would be really sweet functionality if it was tied to the EMR where the actual charges arrive. Of course, this is the challenge of using a system that’s not connected to your EMR.

The cost for this is similar to the other one with $395-495 a month up front and then $29.95 per month for hosting. One thing it doesn’t say is how the charges that Paypal charges will be handled. I’m guessing they pass those on to you the end user as well. Paypal is an amazing platform and great for developers since it costs nothing to get started and use it. However, Paypal instead gets paid on the back end with the highest percentage fees of any other credit card processor. I imagine ePatientPayments will want to switch to something other than Paypal as they grow. The savings of using another credit card processor over PayPal will basically pay for the ePatientPayments and then some.

Conclusion
I think we’re going to see a lot more little services like this pop up. I think a number of them could be very beneficial if they’re integrated or used alongside a great EMR. The other good part is that it seems like using stand alone services like this one will still allow you to be considered a “certified EHR” and possibly receive some of the $36 billion of EMR stimulus money.

Read more…

Has anyone participated in the health social network iMedix? I first read about this idea a few years ago on TechCrunch and it looks like they’re still around and kicking. I really like the idea of an empowered patient. I like the idea of having good information. I’m just not sure that iMedix or many other websites are the places for patients to get that information.

I wonder if iMedix could possibly start partnering with EHR companies to provide their platform of information integrated with a doctor’s portal. I’m not sure the doctor would ever go for it or if they would want to take on that liability. However, iMedix is interesting as kind of a Yahoo Answers for medical questions.

I’ve certainly seen this a few other places on the web and whenever I see it, I think about my experience at the doctor. Usually they don’t have time to answer all of my questions or it feels rushed or other questions just come up after the fact. Plus, I kind of like to know all the nuances of what’s happening. Since I work daily with a number of doctors, I’ve often found myself going and visiting with those doctors to become more educated about the treatment suggested by mine or my children’s doctors. One time my son was prescribed some interesting drugs for Mastocytosis and so I went and talked with the pharmacist I support and learned about the drugs as well. I just wanted to learn everything I could about the treatment and disease.

At the end of the day, how different is it for someone to go on a health website and ask the questions that I asked the doctors and pharmacist I work with? I guess the main difference is the trust factor between information on a website and my colleagues at work. However, the motivation to get more information is the same.

What can’t be discounted is the power of these health social networks to help patients with similar chronic conditions to interact with each other. I find this type of interaction really interesting to follow.

The more I consider what Google Health and Microsoft HealthVault are doing, the more I think that they just might have found the real solution to interoperable health records. I’m still holding out final judgment, but I’m really impressed with some of the things there doing.

For example, Techcrunch reported that Google Health just recently partnered with CVS for Google Health to connect with CVS to try and create a comprehensive pharmacy history. Considering Google had previously signed up Longs Drugs and Walgreens, Google is making good head way towards this goal. No doubt Google Health is also in discussions with Wal-Mart and Target, two of the other major players in this space.

Of course, the next step is to get patients to actually start adopting this technology. I can’t see many pharmacists pushing this feature. In fact, I’m guessing this might be an annoyance for them to have to support. Patients are going to have to force the issue if they want to use this. At least until there’s widespread adoption.

We’ll also leave the privacy issues of these connections for another day as well. Either way, these types of partnerships are like gold for Google Health. It creates a good foundation to build their product. I just still like to see more connections with EHR software vendors. I haven’t seen as many of those happening as I’d like to see.

I just came across a few interesting tweets where Howard Luks, Web 2.0 and HC 2.0 savvy Orthopedist fascinated by Social Media and influence on healthcare delivery, posted his 100 patient “poll” on PHR. His first question was how many people were interested in PHR. The second one was how many patients would want their healthcare data online (cloud). Check out the responses.

66/100 not knowing what a PHR is seems high. I would have guessed more like 95/100 wouldn’t know what a PHR was. The split for those interested in their HC information being online seems pretty representative. Over half of the people don’t care or don’t know. So far no PHR vendor has really given us a reason to care.