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Personal health records - compiled and maintained by patients, but available to providers with the patient's permission - seem to be a market in search of a need. Microsoft launched its PHR service, HealthVault, in 2007, and Google followed suit in 2008 with Google Health. Microsoft has the Mayo Clinic and Kaiser Permanente, among others, as partners, while Google's list includes Harvard Pilgrim Health Care and Beth Israel Deaconess Medical Center. Some, such as the Cleveland Clinic and Walgreen's Pharmacies, work with both. Users can record information in their PHR, or get their providers to add information from their records - if the provider is so equipped and has an agreement with the PHR vendor. Neither Google nor Microsoft is charging for the service, at least so far.

But a recent Forrester Research survey of more than 5,200 consumers showed that while almost a third had an online PHR, the vast majority got them through their health insurer. Microsoft and Google barely registered as players. (See charts, pages 60 and 64) To date, there's not an overwhelming demand for online PHRs from third parties.

Microsoft HealthVault includes this disclaimer, which explains the PHR problem from a provider's point of view: "Information from HealthVault should not be used by health care providers to make treatment decisions without independent evaluation, and only after being copied into the healthcare provider's own system." After reading that, it would be natural for providers and patients to say, "Why bother?" If a provider can't depend on the data without double-checking it, it's probably better off encouraging patients to use its own portal and aggregate their data there.

Kevin Palattao, vice president of patient care systems for HealthPartners, Bloomington, Minn., an integrated provider/payer organization that has its own patient portal, says ultimately, health care should have some equivalent to financial software that automatically gathers all of a user's financial data. But health information doesn't line up as neatly as numbers on a financial statement.