Why are these major players taking this step? Because they believe that giving consumers access to more information about their health care will help them stay healthier, ultimately reducing costs.
PHRs = better health awareness
Managed care plans and self-insured employers hope that as more consumers rely on PHRs, they will be more likely to get tests done on time, follow up on disease prevention, get their children immunized and take other steps that will keep them healthier. Ultimately, that could lead to fewer cases of serious illnesses, fewer hospitalizations and lower costs. And if that happens, insurers might see bigger profits and consumers might see lower premiums.
Simply put, a personal health record is a patient's view of their medical record. It's different than the "official" electronic medical record because the patient can add or remove information from it and can control who views the information.
A wide variety of PHRs are available, including some created entirely by patients. But managed care plans pushing PHRs are building them by posting medical claims data, pharmacy benefits information and lab results from multiple sources to an online record that members can access.
Members can then add a medical history, take a health risk assessment and find information about their specific health conditions. In most cases, payers are enabling their members to share the PHR with their physicians.
Managed care plans believe they are in a perfect position to offer PHRs because they gather information from multiple providers. In contrast, a primary care physician's electronic medical record for a patient might not include the medication records from a specialist who also is treating the patient.
"PHRs can help connect a fragmented health care system," says Archelle Georgiou, M.D., executive vice president of strategic relations at UnitedHealth Group, Minnetonka, Minn. "People see multiple doctors from multiple offices and have multiple medications, and the PHR enables that information to be housed in one single place."
During the two years or so that major payers have been offering PHRs, the biggest challenge they've faced is persuading their members to use them. Some doctors have proven reluctant to get on the bandwagon as well.
Managed care companies want patients to check health records the same way they might check their bank account. But so far, the rate of adoption has been somewhat disappointing, prompting a few payers to offer cash incentives to members who sign up.
Privacy is paramount
Perhaps the No. 1 concern that consumers have expressed, payers say, is whether sensitive medical information that's accessible online will remain truly private. To help address that issue, payers are enabling members to limit who can see the information and what data is populated in the record.
In addition, some physicians and others have expressed serious concerns that PHRs may do more harm than good.
Because many payer-initiated PHRs offer consumers the option of hiding certain information from physicians, this could lead to a misdiagnosis or harmful drug interactions, some opponents contend. Some physicians also point out that the information gleaned from claims may not accurately reflect all the complex details of a clinical diagnosis.
As a result of the slow adoption rate, the jury's still out on whether PHRs will achieve payers' cost-cutting goals.
So far, the rate of PHR adoption has been higher among those enrolled in consumer-driven health plans, high-deductible insurance plans in which the member is responsible for much of the upfront costs.
Because enrollees in these plans are accountable for more of the cost, the PHR acts as a starting point for them to access information and find out how they can save money and manage their health. Enrollees can access a PHR linked to their health savings accounts, which the member and employer fund to pay for the initial health care costs.
Although most consumers want to have easy access to their medical records, they have apprehension about having sensitive data online, according to a recent national survey.
Ninety-six percent of Americans say it's important for individuals to be able to access all of their medical records to manage their health, according to the survey of consumers sponsored by the Markle Foundation, a New York-based organization focused on accelerating the use of technology in health care and national security.
Also, 97% of those surveyed say it's important for their doctors to be able to access all of their medical records to provide the best care.
"The survey shows that consumers want access to medical information to make sure it's accurate, to improve doctor-patient communication and to prevent the duplication of information," says Zoë Baird, president of the Markle Foundation.
Verifying vaccines
But consumers have many other good reasons for improving their access to information, says Lynne Dunbrack, program director for health payer research at IDC Corp., a Framingham, Mass.-based research and consulting firm. For example, parents want PHRs for their children so they can check vaccines and other information at any time.
Also, many aging baby boomers want to keep track of their health conditions online. "There are more consumers with multiple chronic conditions, and you have to manage them and have one place where all that information is located," Dunbrack says.
In the Markle survey, 90% of respondents said a PHR would be important to track symptoms or for help with disease management. Also, 83% of parents would be interested in using a PHR to check on their child's health, such as tracking dates for immunizations.
Be the first to comment on this post using the section below.