Three grants of about $600,000 each from the Washington State Health Care Authority helped start the pilots early this year. Sponsoring organizations include St. Joseph Hospital Foundation in Bellingham, Community Choice Healthcare Network in Cashmere and Inland Northwest Health Services in Spokane. The state funds paid for technology upgrades and the building of data sets to support the banks, with sponsoring organizations shouldering most of the costs, says Juan Alaniz, project manager at the state health care authority. Madigan Army Medical Center in Tacoma is conducting a fourth, independent pilot.
Under the model, sponsoring organizations - or contractors to the sponsors - serve as trusted entities controlling a health records bank. The bank collects a patient's paper and electronic medical records from physicians, hospitals, laboratories, pharmacies and other sources. Patients have control over who accesses their data. A health records bank generally would be funded through account fees charged to individuals or sponsors, such as a provider organization or insurer. There is no initial cost for consumers participating in the three pilots partially funded through the state. One goal of the pilots is to determine the feasibility of a financial model, such as charging fees or seeking employee sponsorships.
The sponsors have built technology platforms to connect health data holders to the health records banks and sort and organize the data. Consumers will use personal health records and related tools from Google Health and Microsoft HealthVault to view their data, enter additional information and share it.
Enrollment started in March, and about 5,000 consumers had enrolled by October. Proponents had hoped to get 18,000 enrollees by December "and that is one of the lessons learned," Alaniz says. "We knew it would be a challenge to introduce disruptive technology. It has not been easy to engage consumers in a meaningful way."
Adoption of PHRs hasn't been high, but the Quicken consumer financial management software also was slow to catch on, says Richard Onizuka, director of health care policy at the Washington State Health Care Authority. When Quicken came out, consumers had to enter all the data, he recalls. Now, consumers can download their financial data from their bank. "Consumers will make decisions based on the value and convenience they get," he adds. "So we need to get industry data in the PHR."
The tools for automatically importing patient data into PHRs are beginning to become available, Onizuka notes. Still, consumers have not adopted PHRs from employers, government agencies and insurers populated from claims data because they don't trust those entities hosting the health information, he contends.
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