The Evolution of Personal Health Records
I shattered my right pinky finger a year ago last March in an ice hockey game and the most difficult part of the whole ordeal -- well, aside from the surgery that reconnected the appendage and the subsequent metal pins protruding just above my knuckles -- was trying to coordinate communications between my hand surgeon and my physical therapist.Despite having offices on the same floor of the same building, collaboration was severely lacking. When it came to designing casts and splints or setting therapy timetables, the two always had differing opinions. One never knew what the other was doing. And I wasn't much help, jumbling and confusing bits of information they had communicated to me.
I'm currently working on a news analysis story for an upcoming issue of Insurance & Technology on personal health records (PHRs), and whenever I sit down to interview a source for the story, I can't help but think back to my poor, and now slightly deranged, pinky finger:
How would treatment have been improved had a web-based record been available?Would I have had a better understanding of my own situation if I could have accessed and reviewed that information online?
Why didn't the referee call a penalty on the player who almost slashed my finger off?
And I've come to this conclusion: Right now, PHRs can be sources for competitive differentiation for a health insurer by aggregating data from different sources such as surgical centers, hospitals, insurance claims and primary care providers and then presenting it an easy accessible way. However, the real value will come when the industry settles on a basic set of standards, making it possible for individuals to bring their PHR with them when switching health plans and/or networks, maximizing savings by reducing medical errors and redundancies.
Rich Gunza, executive director for the Dayton Region at Anthem Blue Cross Blue Shield, says that PHRs are an evolutionary cut above more traditional electronic health records. Anthem recently launched the Individual Health Record (IHR) program in Dayton.
"If you look at an electronic medical record, those are primarily in a doctor's office, but it stays within those four walls. It's a stand-alone record," Gunza explains. "The individual health record looks more like a bicycle wheel with a hub and spoke. It's a collector of different pieces of medical information. What an IHR does that's different is it takes those very technical pieces of information and synthesizes it. It takes those thousands of pieces of information, extracts what's important and makes it available for the physician and patient to use."
Anthem's IHR initiative and many similar projects from other organizations are good news for consumers looking for more efficient and less complex health care. However, the surge in separate PHR projects can also be viewed as stumbling towards the end goal -- a unified digital health grid that transcends a particular hospital network or healthplan. After all, what good is a robust and easy-to-use PHR if a consumer can't take it with them if they switch jobs and thus switch health insurers?
Gunza, for one, says that it's yet to be determined how things will play out. He compares the current state of things to the VHS vs. BetaMax and HD-DVD vs. BluRay video format wars.
"There are a lot of different methods out there that are being developed and that are, frankly, competing for the same end game, which is how do you provide a member or a patient with easy to use, practical information for them and their doctor?" Gunza says.
InformationWeek Editor-in-Chief Rob Preston touched on this recently when he wrote about the challenges and complexities of setting up a digital health care grid, urging all the players involved to get down to business.
Preston's piece points to a journal study that questions the effectiveness of e-health records and an e-health record collaboration (involving Wal-MART and other big name companies) that is currently on shaky ground. Still, Preston comes to the same conclusion I did after staring at my right pinky finger:
"It's almost embarrassing to still have to argue that medical e-records are critical. They eliminate prescription errors caused by illegible handwriting; they make it easier to follow a patient's care over time; they alert doctors and pharmacists to dangerous drug combinations; they keep doctors apprised of new tests, treatments, and drugs; they put more information at the fingertips of patients; and they reduce costs, just as the conversion of any supply chain process from paper to digital does. Get on with it."Although a valuable asset for any individual health insurer, Personal Health Records real future depends on industry-wide collaboration.
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