Do It Yourself: Gathering Information

Below you will find a basic template for gathering information for a Personal Health Record. As you will see, the emphasis is on information that will help identify you and keep you alive in case of emergency.

Being able to find and store old images, lab results, and consults for your record would be a "nice touch", but concentrate first on things like lists of allergies, medications, and major health issues. Any emergency room physician would be thrilled to have that basic information; more detailed, historical data can be tracked down at a later time.

As far as getting your hands on data for this part of the project, start with the medications you take every day. Call or visit your local pharmacy if you need more information to round out the list.

For the history section, write down all the major issues you can remember. (Comparing them against the medications you take is a good way to start--for example, if you take blood pressure medication, it is a pretty safe bet that you have hypertension.)

If you have trouble remembering the names of your health issues, i.e. coronary artery disease versus myocardial infarction, call your primary care doctor and ask them to release a copy of your "history and physical" form from your chart (you may need to sign a release). If you have any sort of heart trouble, a scanned copy of your most recent EKG would be a great thing to include on the record.

Lab results and copies of specialty consults can also be obtained through your primary care physician. Lab results may also be available through the company that does your lab work, i.e. Quest or LabCorps.

Here is the template:

• Name
• Address
• Date of Birth:
• Blood Type
• Code Status and the location of Living Will, if relevant (consider adding a copy here, the legality of this electronic copy will vary from state to state):
• Contact in case of emergency:
• Primary Care Provider:
• Pharmacy (include address and phone number):
• Allergies:
  
• Medications: (include name, dosage, frequency, and other special instructions)
  
• Past Medical History:
• Surgical History:
• OB/Gyn History: (number of pregnancies, number of live births, complications, etc)
• Social History: (occupation; tobacco, alcohol, and drug use; who you live with now)