While the HITECH incentives are intended to move the country toward comprehensive use of EHRs, many HIT proponents have been banking on patient demand for access to their records as the real key to pushing providers forward.

The problem, however, is that if the use of Personal Health Records (PHRs) is taken as a good indication of growing patient interest, that demand is still barely registering.

This observer points to a recent report from CSC  that claims "despite the renewed buzz and some well-publicized initiatives, the reality is that we are still no closer to a true personal health record than we were five or 10 years ago.”

Not surprisingly, in perusing the PHR landscape through the eyes of a number of stakeholders, she finds more than one possible reason for the slow rise of PHRs.

One longtime observer argues that it still is "far too difficult to collect one's personal health information”, while the CEO of “an employer consortium that offers a PHR platform (says) that many PHR platforms are not patient centered.”

Yet another, a former employee of the now-defunct Google Health, argues that “Because health care is not a true market-based commodity in this country, patients end up being lousy health care consumers. Unlike the banking, airline and retail industries, this makes it much harder to convince a broad array of consumers to engage in a service that helps them organize, manage and share their medical records online."

These points all make sense, but we wonder how, or perhaps just if, the slow rise of PHRs will impact the political support for programs like HITECH. We’ve argued before that budget battles will continue to rage for the foreseeable future, but the case made by HIT proponents for ongoing federal investment would certainly be strengthened if they could point to, say, a strong increase in the number of people using PHRs to manage their own health information.

Thus far, however, while you could say there’s been an increase, you couldn’t tag it with the adjective “strong.”