While the Department of Health continues ploughing good money after bad in an attempt to maintain its glorious technological isolation from the grubby world outside, our American cousins forge ahead, placing their faith in the very latest encryption software and the hottest and highest of firewalls.

There is certainly none of this stuff about NHS-wide intranets in the US, where at least two companies recently launched web-based medical records services offering 'access to your detailed medical information 24 hours a day, seven days a week - anywhere in the world'.

MedicalRecord.com claims to address an endemic problem of US healthcare: records left scattered in medical institutions around the country as people move, switch insurers or change healthcare providers. And it produces testimonials. 'I had a severe allergic reaction while travelling in Mongolia, and the doctors were able to immediately access my medical records through the Internet,' writes a satisfied customer.

WellMed, which describes itself as 'the leading online provider of health- risk analysis tools', says health portals collectively boasting more than 10 million users plan to offer the company's health profiling system to their members, while some big corporations are putting it on their staff intranets.

Both companies also offer consumer-oriented health news and health advice, which may be what MedicalRecord.com means by 'adding value to audience- rich vertical portal sites by keeping users engaged and online'. It's difficult to tell. The running debate here over privacy is a feature of the US debate, too - but with a twist. When Congress passed new healthcare legislation earlier this year it wanted everyone to have a universal health identification number. The idea was dropped because of concerns that a single database offered too much potential for abuse.