Mark Holland of Sandy Springs has vivid memories of watching his mother struggle to stay on top of his grandfather's health care.

"He had a couple of conditions, and he literally took over 50 medications a day," recalls Holland, noting that his grandfather couldn't remember all those medications, let alone the instructions on how and when to take them.

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Holland's mom did her best to write all of this medical information down, but it required constant updating, and the task was overwhelming.

"It all came to a head one day when around midnight my grandfather developed a detached retina," says Holland. His grandfather managed to get himself to the emergency room, but physicians couldn't treat him until they knew what drugs he was taking. "They had to track my mom down, and she had to get the paperwork and drive it to the hospital," says Holland. "They lost valuable time, and I knew there must be a better way."

Unfortunately, this type of scenario plays out every day in doctors' offices and emergency rooms across the country, often resulting in delayed treatment, medical errors, and unnecessary expense.

Such problems would be greatly reduced if health plans and providers agreed on a common method and platform for tracking and exchanging health information, but until that day comes, a growing number of consumers are turning to personal health records or PHRs to collect and manage their own personal and family health information.

Best choice depends on you

There is a growing number of PHR alternatives available, ranging from Internet-based services and software tools to old fashioned paper-based products. But finding the right solution to your health information needs really boils down to your personal health circumstances and lifestyle, according to Jill Burrington-Brown, the manager of professional practice resources for the Chicago-based American Health Information Management Association (AHIMA), a group that is working on standards for PHRs.

The organization maintains a Web site — http://www.myPHR.com — that provides guidance on how to select an appropriate PHR as well as information on dozens of PHR applications. The different PHR formats, and the costs associated with using them, vary widely, so it pays to do some homework on the front end. For example, consider the features and the expense associated with these three alternatives:

The simple approach

MedsFile.com is offered by the Vinings, Ga., company that Holland formed in 2004, as a result of his own family's struggles to keep up with his grandfather's complex medication information. What MedsFile provides is a personal, secure Web site that enables patients and caregivers to input and store whatever information they choose regarding medicines, supplements, physicians, immunizations, emergency contacts, and allergies. "It is basically a personal medical diary that is easily accessible by the patient, his or her caregivers, and doctors," says Holland.

It takes about two minutes to sign up for the service online, and it costs $3 to $4 dollars a month to maintain, depending on whether you want to be billed by the month or the year, says Holland. A MedsFile can be accessed, changed, or printed from the Web site at any time. And it may be viewed from a mobile phone. Further, in the near future, Holland plans to add a new feature to the service that will alert users of any potential adverse reactions whenever they enter a new medicine or supplement. "We really want to keep this as simple as possible right now," says Holland. "We are targeting baby boomers who may not be the most computer savvy people out there, and the elderly, some of whom have computer experience, but we don't want to get too overwhelming with this."

Take it with you

If maintaining your own records seems like too much of a burden, and you are constantly on the go, you might want to consider a PHR like VitalKey. Created largely by physicians in 2004, VitalKey enables the user to carry around all of his or her health information on a flash drive that you can attach to a keychain so that, wherever you are, medical providers can easily access your information by simply plugging the VitalKey into the USB port on a computer. Further, all of your records are organized and maintained by an intermediary from VitalKey who has your permission to continuously retrieve that information directly from your providers. "We work with consumers on a subscription basis, and what they are really subscribing to is having their own nurse act as their agent in going out and getting their records and organizing them," explains Tom Blue, chief operating officer of the Glen Allen, Va.-based company.

The cost of a VitalKey subscription ranges from $8.95 per month for people younger than age 45 to $29.95 per month for people 75 and older, and Blue notes that most subscribers have been referred to VitalKey by their physicians. For example, Dr. Laura Beaty, a primary care physician in Atlanta, recommends VitalKey to the small subset of her patients who have serious diagnoses and many prescription medications and who travel a fair amount.

"I have a particular patient right now who is at M.D. Anderson Cancer Center [in Houston, Texas] for a consult, and all he had to do was take his VitalKey with him, and all the different doctors he is seeing there just plug it in ... and they get all of the information at a moment's notice," explains Beaty. However, she cautions that when you carry all of your health information around on a keychain, there is a risk that it could slip into the wrong hands, so consumers need to be aware of that risk.