Aetna's Supposed Healthcare IT Prowess: A Double-Take

A few weeks ago, I noted that Aetna is showing interesting -- if still nascent -- signs of transforming its business, in part due to its seemingly aggressive embrace of healthcare information technology. My BNET colleague Ken Terry echoed this theme when he recently pointed out Aetna's sizable lead over its larger rival, UnitedHealth Group, in terms of offering personal-health records and mining medical and claims data to help its members search for useful health information.

All that may well be correct so far as it goes. But I'm an longtime Aetna member myself, and some of my recent experiences with the company demonstrate just how low a bar an IT "leader" in the health-insurance industry has to clear. Let's just say that it isn't exactly pretty.

Start with Aetna's much-vaunted personal-health record. I've been on an Aetna plan for almost a decade, so I figured they'd have plenty of data to play with even though I've been pretty healthy over that period. Not exactly. My Aetna PHR doesn't know my phone number, marital status (despite having held family coverage for most of the last decade), height, weight, blood type or blood pressure. Now, maybe not all of this information is available in the insurer's claims data -- but that says a lot about the weakness of that particular approach, IT commitment or no.

The PHR does have a list of every doctor I've seen in the past ten years, which is nice, and it seems to have tracked various travel and seasonal vaccinations pretty well. But its prescription record is pathetic -- it lists two medications I took briefly four years ago, but there's no mention of the half-dozen-odd times I've taken a course of antibiotics or some other prescription. Best of all, the PHR knows exactly what blood tests I got at my last physical -- but it has no idea what any of the readings were, and in fact doesn't even seem to know the "normal" range for the various tests.

Absent my taking time to fill in a lot of data for the PHR, in fact, it's as close to useless as just about anything I've seen. (So there's no way I'm about to experiment with exporting this sad collection of data to Microsoft's HealthVault or Aetna's own internal data-sharing network.) Sure, some information may be missing because my primary-care doctor only recently started keeping computerized medical records, but Aetna is supposed to be able to plumb pharmacy and laboratory records for this data as well. If my experience is any indication, they've vastly exaggerated their capabilities in that respect.

The second issue may seem trivial by comparison, although I think it's also telling. I recently changed from a group to an individual Aetna plan, and for various reasons found it easiest to pay my premium via credit card. Doing so has entailed a monthly call to Aetna, each taking five to 10 minutes to navigate voice menus and then read my credit-card number to someone in the billing department.

So I figured I'd ask about having my card billed directly. Could I arrange that online? Heck, no -- Aetna apparently has no ability to process online transactions by individuals. Could I arrange it by phone? Heck, no -- although the billing person was kind enough to offer to send me the appropriate forms. By mail. In, as it turned out, a hand-addressed envelope (click for a slightly larger image -- and yes, I've blurred my address):

The forms themselves appear to be blurry xeroxes of an Aetna application pamphlet of some sort. Why, exactly, it made sense for this unfortunate Aetna staffer to make copies, stuff them in an envelope and then address it by hand still kind of boggles the mind. But it speaks volumes as to how much progress Aetna has made applying modern IT to operations that directly affect its members.