A Shot in the Arm for Health Records

By Kristin Hunt

Jun. 2, 2008

Use of electronic personal health records could increase substantially if Google Inc.’s consumer-driven model launched in May is successful, benefit experts say.

    Many employers have been skeptical about the value of personal health records, saying employees are concerned about privacy and likely won’t take the time to maintain the records. But with companies such as Google rolling out its Google Health PHR and Microsoft Corp. launching a similar product, which so far is limited to its business partners, experts say the concept may take off.

    Products like Google’s and Microsoft’s “will increase awareness and, therefore, use,” says Barbara Cox, a senior principal and national practice leader for information management systems at Noblis Inc.’s Center for Health Innovation in Falls Church, Virginia.

    Electronic personal health records, already offered by several major insurers and employers, allow individuals to input their health and medical information via software or online portals. Patients own the data and determine who may access the records, such as family members, health care providers and medical plans.

    Proponents say personal health records can make the system more productive and efficient. Doctors could follow patients’ health histories more easily and review them more thoroughly, improving diagnoses and reducing mistakes.

    Promoting employee use of personal health records is in line with the trend toward engaging employees in their health care, Cox says. “If individuals are more engaged in their health, then they’re going to take steps to improve it, which lessens the health care cost,” she says.

    Electronic personal health records most commonly are offered by health plans for a fee paid by the employer, says Cathy Tripp, Watson Wyatt Worldwide’s Minneapolis-based national leader for consumerism. Some employer groups have purchased stand-alone personal health records from providers such as WebMd or Mayo Clinic. Most current models, though, aren’t interoperable or portable, she says. If users change health plans, they may have to set up a new record.

    Additionally, some employers have formed coalitions to sponsor their own models, such as Dossia, a platform supported by eight large employers that is intended to be a lifelong personal health record when it does launch.

    In Kansas City, Missouri, 24 area employers have formed CareEntrust, which works with insurers to set up an electronic community health record that collects medical records, laboratory test data and pharmaceutical information for consumers, physicians, insurers, benefit managers and employers. Employees at participating companies can use the information to build their own personal health record. If they change jobs within the consortium, they can move their personal health records between participating companies. If an employee moves outside the employer network, though, the personal health record is lost.

    Still, it’s a worthwhile effort, says Stephen Best, assistant vice president and director of compensation and benefits for JE Dunn Construction Group in Kansas City, a founding member of CareEntrust. “This is an investment in something we think is going to provide a return,” he says.

    Computer retailer Dell in Round Rock, Texas, has offered employees access to personal health records since 2004, according to a company spokesman. In 2006, it began working with WebMD to provide automatic, secure claims-import capabilities to its personal health record. Employees can track and manage data on procedures, conditions and medications. According to the company, “We pursue this as we believe arming employees with easily accessible information will help make them better consumers of health care and information that helps them manage their own wellness.”

    For personal health records’ advantages to play out, however, people have to use them. Speculation has surrounded whether Google Health and Microsoft HealthVault will increase personal health record utilization because of their brand names and ability to access the personal health records anywhere at any time at no cost to the consumer. HealthVault has yet to set a date to go live among individuals.

    Both offerings have similar capabilities. Individuals can store information such as lab test results and family health histories, provide health care-related search features and wellness regimens, and refill prescriptions and schedule doctor appointments.

    However, the Google and Microsoft personal health records are portable and interoperable—qualities the private models are missing, Tripp says. They are the first products with national reach that can follow patients regardless of where they work or the health plan they use, Cox says.

    Throw in the companies’ trusted brand identities with user accessibility, and it seems likely they will prevail in the personal health record market, Cox says.

    On the flip side, Tripp says neither model is connected to a major health plan and may never be, since health plans are developing their own personal health records. Health plans have access to patient data and can put that into members’ records, requiring members to do less.

    For any personal health record model to dominate or even work at all, the user experience must become less burdensome and more secure, experts say.

    Ray Brusca, vice president of benefits for Black & Decker Corp., says the Towson, Maryland, power tool maker isn’t promoting any electronic personal health records to employees, who do not want the responsibility of gathering and maintaining the data. “I don’t mean to be a skeptic,” he says, “but I just don’t see people taking the initiative.”

    Additionally, Cox says security and privacy issues are a concern because of personal information being stored online. Employers don’t want to be liable for breached information, and employees don’t want their information to be misused.

    Because health care is outside the core business models of Google and Microsoft, JE Dunn Construction’s Best says individuals may feel more comfortable using platforms from companies focusing solely on electronic personal health records or health care services such as CareEntrust or Dossia. Alternatively, Tripp says individuals might feel more comfortable using public platform models because they are independent from their employers and insurers, organizations they trust very little when it comes to private information.

    Ultimately, no model is complete and no one solution is recognized as the best, Tripp says. But a more competitive marketplace likely will improve personal health record applications and drive utilization, she says, which is a good thing for employers.

    “The good news is that all of these emerging players are pushing the industry to focus on data security, privacy, portability and interoperability,” Tripp says. “These four principles are critical components for all of the solutions and will drive the next-generation functionality.”

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