http://www.nytimes.com/2009/04/18/health/18patient.html?ref=healthThere is obvious appeal in the idea of an electronic file controlled by the patient but accessible with his or her permission by doctors, hospitals and insurers — a file that could be continually updated with all new medical procedures, prescriptions and tests. That kind of detailed record and seamless communication could improve the quality of health care and help reduce dangerous medical errors. And by improving the efficiency of medicine, it might also help curb the nation’s skyrocketing health care costs.