The Cleveland Clinic started a pilot program last fall, using HealthVault in conjunction with different devices to manage three chronic conditions, including diabetes, heart failure, and hypertension. (Other compatible devices include blood-sugar monitors; a peak-flow meter, which is used to measure an asthmatic patient's ability to push air out of the lungs; a heart-rate monitor; scales for measuring weight; and a pulse oximeter, which is used to measure oxygenation of the blood.) Scientists will keep track of how effective the system is at changing both treatment and patient outcomes. "We want to gather information in near real time and, more importantly, act on the results of that information in a more continuous fashion," says Harris. "The goal is to produce better control of blood pressure and diabetes."

Motivated patients who don't have access to this kind of program can use a number of applications available through HealthVault to manage specific conditions, such as a tool from the American Heart Association that allows patients to manage blood pressure, blood glucose, cholesterol, weight, nutrition, and physical activity. While many of these same tools are available in HealthVault, Sean Nolan, chief architect of the Microsoft Health Solutions Group, says that in the long term, HealthVault will function more as a database for storing applications, while third-party applications will help patients organize and act on it.

While I'm excited about this new way to track my blood pressure, it's not yet clear if I represent the average patient. Topol's team is collaborating with HealthVault on a genomics project at Scripps in which all 4,000 patients participating in the study opened HealthVault accounts. They all entered medical data into their record with the help of their physicians, but he says that few continually enter blood-pressure and other information. "It's not easy to get people to use HealthVault in a religious way," Topol says. "A lot of people set it up, but they are not good at putting data into it and keeping it updated."

Topol says that such home health monitoring tools are a step in the right direction, but they are not enough. "It relies on a patient stepping on the scale or putting on the blood-pressure cuff," he says. In the future, he says, Band-Aid-like sensors on the skin might monitor blood pressure or heart rate continuously. "You don't have to do anything to get the reading--that will be a quantum jump," he says.