title: The military health system's personal health record pilot with Microsoft HealthVault and Google Health.
abstract: OBJECTIVE
  To design, build, implement, and evaluate a personal health record (PHR), tethered to the Military Health System, that leverages Microsoft® HealthVault and Google® Health infrastructure based on user preference.
  
  
  METHODS
  A pilot project was conducted in 2008-2009 at Madigan Army Medical Center in Tacoma, Washington. Our PHR was architected to a flexible platform that incorporated standards-based models of Continuity of Document and Continuity of Care Record to map Department of Defense-sourced health data, via a secure Veterans Administration data broker, to Microsoft® HealthVault and Google® Health based on user preference. The project design and implementation were guided by provider and patient advisory panels with formal user evaluation.
  
  
  RESULTS
  The pilot project included 250 beneficiary users. Approximately 73.2% of users were < 65 years of age, and 38.4% were female. Of the users, 169 (67.6%) selected Microsoft® HealthVault, and 81 (32.4%) selected Google® Health as their PHR of preference. Sample evaluation of users reflected 100% (n = 60) satisfied with convenience of record access and 91.7% (n = 55) satisfied with overall functionality of PHR.
  
  
  CONCLUSIONS
  Key lessons learned related to data-transfer decisions (push vs pull), purposeful delays in reporting sensitive information, understanding and mapping PHR use and clinical workflow, and decisions on information patients may choose to share with their provider.
  
  
  CONCLUSIONS
  Currently PHRs are being viewed as empowering tools for patient activation. Design and implementation issues (eg, technical, organizational, information security) are substantial and must be thoughtfully approached. Adopting standards into design can enhance the national goal of portability and interoperability.
authors.affiliation: Clinical Informatics Department, Walter Reed Army Medical Center, Washington DC, USA. nhan.do@us.army.mil
authors.forename: Nhan V
authors.initials: NV
authors.lastname: Do
authors.forename: Rick
authors.initials: R
authors.lastname: Barnhill
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Heermann-Do
authors.forename: Keith L
authors.initials: KL
authors.lastname: Salzman
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Gimbel
mesh_terms: D000328:Adult; D000368:Aged; D057286:Electronic Health Records; D005240:Feasibility Studies; D005260:Female; D055991:Health Records, Personal; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D057240:Patient Preference; D010865:Pilot Projects; D012984:Software; D014481:United States; D014861:Washington