personal health record

Key players agree on PHR framework

Anne Zieger — Sun, 29 Jun 2008 12:37:17 -0400

A group of the leading lights in the PHR world have come together to endorse a PHR standard, potentially putting to bed the initial arguments over what a PHR actually is and shifting participants' energy to improving features. Connecting for Heath's "Common Framework for Networked Personal Health Information," which was developed over a number of years, has gotten the thumbs-up from Google, Microsoft, WebMD, Dossia, Aetna, the Blue Cross and Blue Shield Association and America's Health Insurance plans. A number of provider organizations were involved in the development of the framework and have endorsed the the final result, including Geisinger Health System, the VA and Partners HealthCare.

While the framework should help a great deal in creating interoperable health data sets, it won't resolve a key legal issue--whether these new patient data compilations should be protected under HIPAA. Right now, the majority of entities offering PHRs--such as Google, Microsoft and WebMD--aren't defined as "covered entities" by HIPAA, and so they aren't technically required to meet HIPAA standards. The players also face ongoing struggles over how to protect privacy, which isn't defined in the framework.

To learn more about the framework:
- read this Modern Physician piece (reg. req.)

Related Articles:
AHIMA demands better PHR privacy protections
Addressing ID verification could spur PHR adoption
HIPAA privacy officer job expanding quickly

Google, Microsoft PHRs sign health plan partners

Anne Zieger — Mon, 16 Jun 2008 17:58:45 -0400

The PHR war between Google, Microsoft and rivals seems to have reached a new stage, with Google and Microsoft scoring major insurance partners this week.

Google Health has just recruited its first insurance company to participate in its PHR program. Blue Cross Blue Shield of Massachusetts, the state's largest insurer, will let its members create PHRs using Google's technology. When the project is fully ramped up this fall, BCBSMA members will be able to important their claims data into their Google Health profiles. The PHR will allow patients not only to store medical records and insurance data, but also to download them from other connected providers.

While BCBS of MA is the first insurer to come on board, Google Health has many other existing partners, including Beth Israel Deaconess Medical Center, the Cleveland Clinic, Walgreens, CVS/Caremark, Minute Clinic, Medco, Longs Drugs and RxAmerica. Microsoft, meanwhile, has signed a deal under which Kaiser Permanente will bring MS's HealthVault platform together with KP's personal health records for use by Kaiser employees and their doctors. More than 2.2 million of Kaiser's members use its existing PHR, called My Health Manager. Kaiser will now use HealthVault technology to expand My Health Manager's capabilities. The new combined platform will begin pilot testing this summer.

To learn more about these deals:
- read this Boston Business Journal article

Related Articles:
Google Health beta launches
Reaction to Google Health service positive
HIMSS08: Google unveils details of PHR
Google begins storing medical records

NAHIT name game gives some vendors a headache

Mon, 09 Jun 2008 06:59:55 -0400

In theory, it doesn't make sense to move ahead with major IT initiatives until the industry has at least some clue as to how to define key terms. However, a recent effort by the National Alliance for Health Information Technology (NAHIT)--particularly in defining the difference between EMRs and EHRs--seems to be creating as many problems as it solves. Over several months, NAHIT came up with definitions for key terms in HIT, including EHR, EMR, personal health record, health information exchange and regional health information organization. Most notably, as NAHIT defines things, an EMR is a record used internally in a medical practice that can't share information with other practices, while EHRs can do so.

The problem with this is that NAHIT seems to have defined some vendors right out of their marketing position. There are several companies that use the term "EMR" to define themselves, such as NextGen Healthcare Information, and have gotten their interoperability certification from the CCHIT. If they have to go back and rebrand themselves as an "EHR" they'll be a bit annoyed, to say the least, officials note.

To learn more about the terminology dispute:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
CCHIT makes EMR certification simpler
CCHIT gets official, approves new vendors

Google Health beta launches

Tue, 27 May 2008 06:59:58 -0400

Sound the trumpets: Google Health has launched its official public beta of its personal health record. While Google's offering theoretically goes head-to-head with products like Microsoft's Health Vault, as well as offerings by WebMD and Revolution Health, as the home page to the world, Google is uniquely positioned to change the game if it can simply execute consistently and well on the PHR model--at least that's our view here at FierceHealthIT.

The much-anticipated service, which has been in private beta for several months, offers users the ability to create a personal health record, import medical records, laboratory test results and pharmacy data, and search for physicians. Google Health also links up consumers with a variety of online health services, including e-consults from the Cleveland Clinic, Medem's iHealth portal linking doctors and patients online, a handful of services turning a patient's existing paper records into digital form, a diabetes monitoring tool and a prescription reminder service.

In the past, adversaries have suggested that Google's data may turn out to be less secure than other forms of medical records. For one thing, users access the records using the same name/password combination they use for other Google services (such as Calendar and Gmail), leaving the possibility that a comparatively simple Internet exploit could expose their medical records. Also, other critics note that Google isn't bound by HIPAA, which could lead to misuse of the health data at some point. Will these be issues? I guess we'll find out.

To learn more about the Google Health launch:
- read this story from the New York Times

Related Articles:
HIMSS08: Google unveils details of PHR
Google begins storing medical records
Microsoft kicks off PHR initiative

SPOTLIGHT: World Privacy Forum sounds alarm over PHR services

Mon, 25 Feb 2008 06:59:52 -0500

As we've discussed elsewhere, companies like Google and Microsoft (plus many smaller competitors) are determined to establish a beachhead in the personal health record space. That has some privacy advocates alarmed. Just in case consumers ask you what the risks associated with PHRs are, you may want to read the questions raised Pam Dixon, executive director of the group. Generally speaking, she's urging consumers to consider whether such platforms force them to give up more control over their medical data than they'd expected. Article

Wal-Mart, partners pilot Dossia PHR

Mon, 28 Jan 2008 06:59:58 -0500

After more than a year of wrangling--and one initial development effort gone bad--Wal-Mart and a team of fellow corporate giants are finally pilot-testing Dossia, their massive PHR effort. Right now, the pilot is tiny, including only about 20 Wal-Mart employees and an equally small handful of employees within the other partner firms. But the Dossia partners, who also include Applied Materials, AT&T, Pitney Bowes, Cardinal Health and Sanofi-Aventis, ultimately hope to extend the PHR to more than a million employees and dependents. The PHR technology used by Dossia is based on Indivo, an open-source PHR system developed by Children's Hospital Boston in 1998.

Founders of Dossia must be relieved that they're finally getting into beta testing. The project had originally gotten off to a difficult start when the group's relationship with its original main development contractor, Omnimedix, fell apart in a welter of court actions.

To find out more about the pilot:
- read this Information Week piece

Related Articles:
Giant firms to build personal health record for employees. Report
Huge employee health record effort in jeopardy. Report
Promoting PHR use: Is it a good idea? Report
Blue plans, health industry group plan PHR. Report
Banks to offer help in PHR dissemination. Report
A Google vision for health data. Report

You tell me: What's a PHR?

Mon, 12 Nov 2007 06:59:59 -0500

OK, maybe some of you are sick of hearing me harp on this subject, but I'll ask again--what the heck is a personal health record?

One view comes from America's Health Insurance Plans: "The industry model personal health record (PHR) is a private, secure web-based tool maintained by an insurer that contains claims and administrative information." Makes sense if you're a health plan, definitely.

Or what about AHIMA's take: "[A PHR is]an electronic, universally available, lifelong resource of health information maintained and owned by the individual." Should calm the nerves of the privacy advocates, no?

The HIMSS definition takes us in a slightly different direction: "To enable the goals of reducing medical errors, improving quality of care, and improving the validity of information available to care providers, Personal Health Records (PHRs) function to consolidate an individual's medical information in one place." This one doesn't dwell on a patient's rights so much as the comprehensiveness of the data, which is of course a wrinkle worth considering.

Yes, I think it's pretty clear what the intent of various employer- and healthplan-driven PHRs is (cheaper, better care), but that's not enough. You can know that you want to ride from Phoenix to Denver without knowing what parts are needed to build a car.

I'm taking up this issue again, in part, because that the indefatigable folks at HL7 are voting on a functional PHR model over the next few weeks. While I'm delighted to see some consensus building on key PHR functions (such as wellness reminders or prompts to look at lab results), that still begs the question of what the ultimate goal of a PHR is. Quick: tell me in one sentence what your PHR effort is trying to accomplish. Not so easy, is it?

When it comes to PHR content, some key unanswered questions include:

* What is the core clinical data set a PHR must contain to deserve the name? Patient medical history, drug allergies, care plans, genetic data, what?
* Does the name "personal health record" imply that it's largely or entirely maintained by consumers, or are consumers merely its custodians?
* What's the benefit of maintaining a PHR? (No, I don't agree that the answer to this is obvious.)
* What is the minimum amount of data a PHR must contain to be useful?

Yes, I realize that health plans, employers, software vendors, standards groups and even consumers will have to do a lot more talking before they arrive at a shared conclusion on these issues--and that technology never moves ahead without some fuzzy logic in between--but in my view things are still too fuzzy. As I see it, it's critical to get bit more clarity on core issues like, say, whether a PHR should be populated by claims data, consumer self-reporting, EMR data or a mix before more dollars are spent. In the mean time, let's not put the cart before the horse, shall we? - Anne

HL7 finalizing PHR standards

Mon, 12 Nov 2007 06:59:56 -0500

Health data standards group Health Level Seven (HL7) has begun accepting votes on whether or not to approve its Personal Health Record Functional Model (PHR-S), an interesting development given that health plans, employers and providers still don't seem to have agreed upon what content a PHR should actually contain. Both members and non-members of HL7 can vote on the standards, though non-members must pay an administrative fee to participate. If approved, the HL7 standards will become a draft standard, and will be refined for two years until they comply with ANSI requirements.

HL7's standards define what functions a PHR and security features are common in existing PHR platforms, and offers ideas on how to share between PHRs or from PHR to EMRs. PHR-S may be the first industry standard defining core functions for PHRs, according to the group's statement.

To learn more about the standards:
- read this HL7 press release (.pdf)
- read this iHealthBeat piece
- read this Digital HealthCare & Productivity article

ALSO: Kaiser Permanente has made personal health records available to all of its 8.7 million health plan members. Article

Related Articles:
Microsoft kicks off PHR initiative. Report
AHIMA promotes PHR use. Report
Giant employers move ahead with PHR project. Report
A PHR turning point. Editorial
AHIMA demands better PHR privacy protections. Report
Blue plans, health industry group plan PHR. Report
Kennedy to file PHR legislation. Report
Banks to offer help in PHR dissemination. Report

AHIMA promotes PHR use

Mon, 01 Oct 2007 06:59:55 -0400

The American Health Information Management Association (AHIMA) is throwing its weight behind the PHR concept. AHIMA has set up a website, myPHR.com, selling consumers on the benefits of compiling a personal health record. It's also conducting a public awareness campaign targeting senior citizens, parents raising young children, home caregivers and patients with chronic conditions. It's likely the campaign will have some impact on its own constituency of 50,000 HIM professionals, as well. After all, there's still not widespread agreement as to what a PHR should actually contain or how it should be accessed; such a campaign should notch up the level of discussion in the HIM circles a bit.

The myPHR.com site includes a "guided tour" of the topic, explaining how stakeholders like insurance companies and providers compile health information and spelling out why leaders believe that consumers should build a record of their own. It also includes a database of PHR tools offered by vendors, though it doesn't endorse any particular technology.

To find out more about the campaign:
- read this Modern Healthcare article

Related Articles:
Giant employers move ahead with PHR project. Report
A PHR turning point. Editorial
AHIMA demands better PHR privacy protections. Report
Blue plans, health industry group plan PHR. Report
Kennedy to file PHR legislation. Report
Banks to offer help in PHR dissemination. Report

Blue Cross of California launches PHR

Mon, 19 Feb 2007 19:01:35 -0500

One of the nation's largest health insurers, Blue Cross of California, has joined the PHR craze. The Blue has launched an integrated wellness, care management and physician communication program--360 Degree Health--with its personal health record model as a central component. The program is intended to better reach the 20 percent of the health plan's members at greatest risk. Like other new PHRs, it's also an exercise in seeing how much useful information patients can actually be tempted to provide. It seems likely that any PHR, no matter how catchy the interface, would have a "shopping cart abandonment" problem.

The new PHR will include both member-provided data and claims data, both of which will be accessible by telephone and the Web. Wrapped around the PHR is a more comprehensive wellness initiative, offering members lifestyle programs, alternative medicine information and live health education. The website also offers interactive online tools helping patients make well-informed health choices.

To get more background:
- read BCC's press release

Related Articles:
GA insurers unveil easy-access PHRs. Report
Groups sink $5.3 million into PHR apps. Report