The Personal Health Record Awaits a Breakthrough
Healthcare providers aren't yet jumping onto the bandwagon of personal health records, despite new offerings from the like of Google and Microsoft.
Six months ago, when those PHR ventures were being treated like the Second Coming of health care, their executives promised that consumers would eventually be able to upload their medical information from hospitals, physician offices, pharmacies and labs into their PHRs. Although there's been some progress, it's been pretty limited compared to what Google and Microsoft offered at launch. Most of what's available to users, in fact, are third-party wellness services, some lab and pharmacy data, and information extracted from healthcare-provider claims.
The amount of claims-based data is growing. For example, Aetna recently announced a program that would allow its members to transfer their claims-based PHRs to Microsoft's HealthVault platform. And Wal-Mart -- a founding member of Dossia, a consortium of large employers that promotes the idea of a lifelong, patient-centered PHR -- has made the Dossia PHR available to employees who receive health insurance through the company.
The problem with such claims-based medical information is that it's limited, outdated, and sometimes erroneous. Moreover, while more than 70 million consumers have claims-based PHRs through their health plans or employers, only a tiny fraction of people use them, with industry estimates ranging from one to seven percent.
When Google Health launched its PHR, the company listed the relationships it had with pharmacy chains, health IT vendors, and a few health care providers, such as Cleveland Clinic and Cedars-Sinai Medical Center. In the nine months since then, other companies have partnered with Google, including Quest Diagnostics -- but none are healthcare systems.
Similarly, when Microsoft HealthVault took wing last winter, Grad Conn, senior director of product marketing for HealthVault, said that "several dozen" health care systems were integrating with HealthVault. But to date, none have been announced. While a few dozen health-related companies are listed on the HealthVault website, the only one that could really be termed a provider is Minute Clinic, a chain of retail clinics staffed by nurse practitioners.
Aside from the fact that only a small fraction of physicians have electronic medical records that are capable of providing this data in digital form, doctors don't seem very interested in PHRs, because they don't yet see how it will help them care for patients. The main exception to this rule are big groups that have PHRs attached to their EMRs, such as the Cleveland Clinic and Kaiser Permanente practices.
Some hospitals see PHRs as a way to give their physicians quick access to information about patients they've never seen before. But they need a standardized format to send data from their clinical information systems into the various PHRs. Such a format -- known as the Continuity of Care Document -- exists, but the majority of vendors haven't yet baked it into their software.