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HIE Opts for Free Health Record Bank

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After extensive market research, the Louisville (Ky.) Healthcare Information Exchange is adopting the health record bank model for assembling personal health records.

But unlike some other organizations experimenting with the model that are charging consumers a monthly fee, this HIE will offer the service free to consumers, providers and payers, says Judah Thornewill, acting executive director.

To fund the effort, the organization will seek grant support and solicit donations from participating providers, payers and other organizations, as well as consumers, Thornewill says. “We think we can build a sustainable business in this way,” he adds. Thornewill estimates startup costs alone will amount to more than $4 million.

Market research determined that physicians and hospitals would not support a PHR project unless a majority of their patients were using one platform, Thornewill says. And consumers expressed serious concerns about the trustworthiness of PHRs, leading organizers to conclude that it was essential that all players serving the region’s 1.2 million residents, including providers, private insurers, Medicaid and employers, must participate.

“Money is the root of all evil when it comes to breaking trust,” Thornewill says. “To build maximum trust, you cannot have a system that’s supposed to save a patient’s life in an emergency, yet charges a fee and turns off service if they don’t pay.”

The HIE’s board, which includes many of the likely participants in the records bank, expects to approve a business plan in May. Then it will begin assessing technology providers, followed by aggressive fundraising in the summer and fall, Thornewill says. If all goes well, a vendor will be selected in early 2009 and a pilot will begin by the following summer.

The records bank will be fed by data feeds from a wide variety of sources, Thornewill says. Consumers, who will control who can access to their data, will be able to use mobile phones as well as the Internet to view their PHRs. They’ll sign up for the program at their physician’s office or a hospital as part of the usual registration process.

A special report in the May issue of Health Data Management will assess the future of PHRs.

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A major success factor for accountable care organizations will be linking caregivers across the spectrum of care delivery. If history is any indication, that's going to be an industrywide struggle.

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