Under an agreement that could represent an early step towards more portable, carrier-agnostic PHRs (personal health records) for consumers, Hartford, Conn.-based Aetna announced in late October that it will provide members with the capability to transfer data contained with their carrier-provided PHRs to Microsoft's Web-based consumer health platform, HealthVault.
"We really see this as the first step," says Dan Greden, Aetna's head of eHealth product management. "This is just the beginning of using a members' personal health data to integrate with other applications and other tools. Down the road, we might even see a scenario where you can integrate it with tools that physicians are using directly."
The extent to which the data contained within PHRs is portable is a key factor when determining the long-term value of online tools like PHRs and similar platforms such as HealthVault. Interoperability will allow users to essentially take their data with them when they switch health insurers. And ultimately, the more these online tools from disparate sources can interoperate, the more complete an individual's health record can become.
Initially, the partnership will allow members to export data from Aetna's PHR into HealthVault. In 2009, users will be able to import data from HealthVault into an Aetna PHR. "We made a very deliberate decision for the first capability to be the ability to take data out of our record and [export] it somewhere else. For whatever reason they are leaving us and going somewhere else, [the member needs] to be able to take their data with them," says Greden.
To integrate with HealthVault, Aetna leveraged PHR portability standards from AHIP (America's Health Insurance Plans) that it helped develop along with several other carriers. Those standards, Greden says, align with the Quality of Care Document (CCD) XML standard contained within industry group Healthcare Level 7's (HL7) guidelines.
"The reason we chose to use the CCD standard is that, much further down the road, we think it will facilitate better interchange with other things that are already in the healthcare technology space," Greden explains. "We really see this as the first step. This is not the end of it."
When Microsoft launched HealthVault in October 2007, it announced several related partnerships with health care providers and other organizations, but no insurance carriers. It was a conspicuous omission, considering that claims data represents what many agree is the most complete and clinically accurate record of an individual's health currently available.
However, the Redmond, Wash.-based company did recognize the value that insurers could provide to HealthVault. "We are talking with many or most of the major [health] plans nationwide," Sean Nolan, chief architect Microsoft's health solutions group said at the time. "We really hope that they do become a key part of the [HealthVault] ecosystem because there is certainly data that consumers have within their plans, both financial and clinical, that would be extremely useful to them."
Greden confirmed that dialogue regarding an Aetna-Microsoft partnership began during the planning stages of HealthVault. "It was clear right away that we shared that view of the benefits of empowering the consumer with good information and good information technology," he says, adding that Microsoft described HealthVault as a platform, as opposed to a PHR. "They've built a platform and an environment. We've got the PHR, which is a valuable tool for members, a valuable healthcare application. We can work together in this context to further our shared goals."
In the fall of 2007 -- when Aetna and Microsoft took the first steps towards portability -- the carrier was only piloting its PHR tool, which it developed with an assist from ActiveHealth Management, a wholly-owned Aetna subsidiary that has another, unrelated partnership with HealthVault. In 2008, Aetna initiated a broad rollout of its PHR to members.
A majority of the 6 million Aetna members that have adopted the PHR have now had it for six to seven months. Adoption is still growing rapidly. "What's interesting is that, of the people that visited [their PHR], 40 percent have come back within a small timeframe. So, we're finding that when people do use it, they're finding it valuable and are coming back," Greden says. "With this capability with Microsoft, they can take their data with them to HealthVault and do more with it there."