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Wal-Mart Takes the PHR Plunge

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Employees at Wal-Mart Stores Inc. who qualify for health insurance are being offered personal health records using technology from WebMD Health Corp., New York, and Dossia, an employer coalition.

The records initially will be populated with claims data from health plans and pharmacies, says Colin Evans, president of Portland, Ore.-based Dossia. Bentonville, Ark.-based Wal-Mart is one of eight corporations involved in the coalition.

Wal-Mart employees who volunteer to participate in the PHR during the ongoing health insurance open enrollment period will be able to designate which providers can see specific data. They also will be able to enter other information on their conditions and histories. And they’ll have access to appropriate educational materials related to their conditions.

Evans describes the PHR as a “three-layer cake.” The first layer involves Dossia gathering information from various sources about individual employees’ health care. The second layer is a data repository fueled by Indivo, which is open-source technology developed at Children’s Hospital of Boston. The final layer is the WebMD application.

The approach is similar to the ongoing PHR platform development efforts of Google and Microsoft Corp.

“The philosophy behind the Dossia effort is we’re trying to uncouple people from being locked into any one aspect of the health care system,” Evans says. For example, Dossia gathers data from multiple sources and enables individuals to access the information from one source.

Dossia plans to work with a number of PHR application vendors in launching projects with its employer sponsors. That way, employees won’t be locked into using one application, Evans adds. That list of vendors will be revealed shortly.

To complete the data in the PHRs, Dossia eventually will make arrangements to gather clinical information from electronic health records systems used by various provider organizations, he adds.

The other members of Dossia will roll out their PHR efforts after Wal-Mart--the nation’s largest private employer--completes its launch so they can learn from the experience, Evans says. The other members are: BP America, Intel Corp., Pitney Bowes, AT&T Inc., Cardinal Health, Applied Materials and sanofi-aventis. Each is providing $1.5 million in start-up funds for Dossia and will pay annual transaction fees for each employee.

More information is available at dossia.org.

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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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