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A web-based patient-centered personal health record (PHR), called the Personal Health Information Management System (PHIMS), has been developed and its usability has been evaluated in conjunction with a referral system, called the Facilitated Accurate Referral Management System (FARMS). To estimate the system requirements of PHIMS for wider clinical use, we have also studied PHIMS usage by analyzing server log files. A preliminary study showed 85% of survey respondents were satisfied with the usability and 94% were satisfied with the overall online referral process. The physicians were satisfied with the content of subjects' personal health information and found the information detailed enough to triage all requested referrals.