Insurance Firms Push Own Digital Health Record Plan

The nation’s health insurance companies, representing 200 million Americans, announced a plan December 13 to create a standardized digital health record that can be owned by members even if they switch insurance carriers.

The announcement comes amid a series of high-profile developments in the effort to reduce health care costs paid by employers and to create products focused on the needs of individual health care consumers.

Washington, D.C., on the subject of digital health records.

But health care experts caution that these initial milestones and spikes in public awareness are baby steps. The industry is far from being able to deliver the improved quality of care and cost savings that is promised with personal health records.

“This might be a first step to get us there, but as a stand-alone activity it has little value,” says Gerard Anderson, director of the Center for Hospital Finance and Management at the Johns Hopkins Bloomberg School of Public Health.

That first step, announced jointly by America’s Health Insurance Plans and the Blue Cross Blue Shield Associations, would create a standard personal health record that could be used by all health plans. At a minimum, the group says, the standards would include: patient information, doctors visits, medications, lab results, providers, facilities, subscriber information, benefit information, family history, physiological information, immunizations, health risk factors, advance directives, alerts (including allergies) and plan of care.

“We felt that because so much of the information for people to have a health record is based on claims filed, we were able to make this available in the short term,” AHIP spokeswoman Susan Pisano says. The plan was also supported by the National Health Council, a nonprofit whose members include health associations such as the American Cancer Society and the Lance Armstrong Foundation.

Pisano says that because of their size, health insurance companies are better equipped than employers to lead the development of personal health records.

“We also realize that more than 200 million people get their coverage through BCBS or AHIP,” Pisano says. “That gives us substantial reach; that gives us two-thirds of America.”

But unless that information can include the kinds of diagnostic detail doctors use to treat patients, the record will not improve health care quality or avoid unnecessary or redundant procedures, Anderson says.

Still, it makes sense to have health insurance companies and employers pay for the effort to develop personal health records, as they will benefit from the cost savings and improved health of insured employees, says Keith Strier, a senior manager in the life sciences and health care practice at Deloitte. And no one else is likely to foot the bill. Anderson says $156 billion in capital investments will be needed over a five-year period to create a national health IT network, of which personal health records would be a component.

Strier sees the decision to create an interoperable health record as a sign of positive cooperation among health insurance companies. The companies, he says, are in a better position than employers to use their product design capabilities to create an interoperable personal health record and bring it to market.

But whether the product comes from employers or health insurers, the goal is the same: to improve the health care of individuals and reduce costs for the employers footing the bill. Health IT experts say the personal health record is at the center of that kind of transformation.

“The proactivity of large employers and major payers signifies the kind of momentum we need in order to drive better outcomes in health care,” Strier says. “And that is not going to happen until [consumers] get more involved, and the personal health record is a main way to make that happen.”

—Jeremy Smerd