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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

AT&T, Covisint and Microsoft plan to expand health network nationwide

Anne Zieger — Sun, 29 Jun 2008 02:02:49 -0400

AT&T, Microsoft and Compuware subsidiary Covisint have announced plans to create a nationwide health information exchange which expands on a smaller network already in place state-wide in Tennessee. In Tennessee, the MidSouth eHealth Alliance and the Governor's eHealth Council had already been running an electronic health network for doctors across the state, running on Covisint's On-Demand Healthcare Platform.

The broader eHealth network will use Covisint's platform and run over AT&T's MPLS network. The new network will give consumers access to records based on Microsoft's HealthVault PHR technology, while giving them the ability to share that information with all providers who connect to AT&T's Healthcare Community Online. The Healthcare Community Online is a virtual private networking-based portal which allows electronic health data exchange between existing systems used by providers and physicians, including large files such as X-ray images, MRIs and CT scans. The AT&T network allows doctors, hospitals, labs, pharmacies and patients to access test results, prescription records and medical histories. It also offers physicians the ability to use e-prescribing functions.

What's interesting here is that the parties involved don't mention what their services will cost, or even what pricing model they'll use (a connectivity charge, a flat fee, a fee per transaction, some other option?). I wonder if this model will be any more affordable than the costly, largely unsustainable RHIOs/HIEs not-for-profit groups and governments have attempted to bring together.

To learn more about plans for the network:
- read this Microsoft press release

Related Articles:
Study: 75 percent of states developing HIEs
RHIOs and HIEs backed by states will win
NJ set to move ahead with statewide HIE plans
Minnesota backs statewide HIE

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

A new paradigm for EMRs--publishing

Mon, 07 Apr 2008 06:59:59 -0400

Over the last year or so, an aggressive little health IT startup in San Francisco has drawn a fair amount of press for its size, including a mention in the New York Times. The company, Practice Fusion, has taken its share of lumps in the blogosphere for its approach, which offers doctors access to a free EMR and practice management system in exchange for accepting targeted advertising.

I understand why people would be concerned that private patient data could somehow leak into advertisers' hands, despite the company's stated commitment to keeping such data private.

That being said, now that the market has gotten used to the idea of advertiser-supported EMRs--much of the bloggish outrage dates from about a year ago, when Practice Fusion first started getting attention--I think it's time to give this model another, more detached look.

Don't get me wrong, I already made it clear that I think Practice Fusion itself is a fairly hot company in and of itself when I named it one of our Health IT Innovators last year. However, my real point is that with virtually all physicians needing EMRs (but few in a position to pay for one) this one company is unlikely to remain alone in this category for much longer.

In fact, to be honest I'm surprised that Google, WebMD or Microsoft hasn't swooped down and recreated Practice Fusion's model using its own tools already. Perhaps this hasn't happened yet because a smaller company like PF can do a better job of building trust (and allaying privacy fears) than a multi-billion-dollar giant. Also, if Google or its peers tried this and got a black eye, it would be far more public and painful than if PF stumbles.

Whatever the current barrier to entry is, though, it won't last forever. Within the next year or two, I believe that ad-supported EMRs will become as accepted as ad-supported magazines, with the ads themselves given equally little attention or concern. After all, looked at another way, patient data is just content--like the words in this newsletter--and running advertising against it is simply an age-old publishing technique. Of course, patient records require extra respect and protection, but it's still content.

That being said, I know not everyone agrees with me. Do you think ad-supported EMRs are appropriate, and are they likely to achieve widespread acceptance? Write to me and let me know.- Anne

Are your PHRs safe?

Mon, 31 Mar 2008 07:59:54 -0400

We've said it before and we'll say it again: The fact that several of the PHR initiatives launched by bigger companies such as Google and Microsoft don't fall under HIPAA medical privacy rules is a little bit scary. While some states have passed "additional privacy standards" to try to keep the Googles and the Microsofts in check by allowing users to control how much access others have to their information, patients ultimately need to understand each individual company's privacy policies and terms of use. I don't know about you, but it seems that with all the recent leaks in medical information, thinking twice about which route you choose for your PHRs wouldn't necessarily be a bad thing at all.

For more:
- read iHealthBeat's article

HIMSS08: Google unveils details of PHR

Mon, 03 Mar 2008 06:59:57 -0500

So, the Google boys have marched into town with their own PHR, which they demonstrated last week for a marveling crowd at HIMSS08. At a modest booth on a side alley at the exhibition, Google was premiering a simple PHR interface consisting of only few text links, including a link to a feature allowing users to search for doctors, and another accessing Google Scholar to search for medical information. The PHR's key function was a link to a utility allowing users to import records from varied provider systems, then store the records online. Of course, Google CEO Eric Schmidt has been making the rounds assuring privacy advocates that the search giant won't share these records without the patient's consent, but as I understand it, since Google's not a provider they're not required to meet HIPAA standards unless they feel like it. How long that will last, particularly if competitors like Microsoft and Revolution Health begin to loosen their standards?

As we've previously noted, the records will be accessible through the same name/password combination consumers use to access other Google features, such as Calendar and Gmail. OK, readers, I'm sure you know far more than me on this front, but isn't that a fairly weak security method to store extremely private information? When I asked one of the young Google-ites manning the booth this question, he brushed it away. I don't know about you, but that didn't impress me much.

To get more background on the Google PHR:
- read this iHealthBeat piece

Related Article:
Google begins storing medical records. Article

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

Microsoft renaming, upgrading healthcare offerings

Tue, 19 Feb 2008 06:59:58 -0500

Hoping to develop a stronger presence in the healthcare arena, Microsoft has renamed its enterprise healthcare technology products--and has set plans to integrate and upgrade them over the next year or two. Microsoft has branded its healthcare technology as "Amalga," a grouping which includes products once known as Azyxxi and Hospital 2000. Since acquiring Azyxxi in 2006, Microsoft has added technology on the architecture side of the software, including a new middle tier based on IIS 6.0. The new version of Amalga incorporating this new technology should become widely available in July. Meanwhile, Microsoft is pushing the former Hospital 2000, now the Microsoft Amalga Hospital Information System, primarily in emerging global markets such as India and Brazil.

OK, so MS's healthcare technology has a new name. The question, now, is whether the software giant will provide more MS-specific functional and integration options which make its technology a no-brainer for Microsoft IT shops. It's not clear from this announcement whether it's gotten to that point.

To find out more about MS's rebranding and development plans:
- read this Information Week piece

Related Articles:
Microsoft steps up to focus on healthcare IT. Report
Microsoft, Mayo Clinic work on HealthVault. Report
Microsoft kicks off PHR initiative. Report
MS vs. open source: the battle gets hotter. Editorial

Addressing ID verification could spur PHR adoption

Mon, 28 Jan 2008 06:59:55 -0500

If providers adopted a set of common practices used for validating the identity of online consumers, not only would their records be safer, it's more likely that the PHR would become popular, according to a new report. The report, which was published by Connecting for health, a public-private collaborative operated by the Markle Foundation, suggests that not only should providers do in-person checking of identities (using, say, government-issued identification), they can also use "knowledge-based authentication," a method which uses a person's knowledge about facts only they should know to establish their identity. In addition, the group recommends using confirmed identities managed by other reliable parties, such as financial institutions.

To get more information on the group's recommendations:
- read this Healthcare IT News item
- read the Connecting for Health paper (.pdf)

Related Articles:
Medicare tests PHRs in South Carolina. Report
You tell me: What's a PHR? Editorial
Microsoft kicks off PHR initiative. Report
AHIMA promotes PHR use. Report
Giant employers move ahead with PHR project. Report
A PHR turning point. Editorial

Medicare tests PHRs in South Carolina

Tue, 22 Jan 2008 06:59:56 -0500

Working with a group of outside contractors, CMS is testing a PHR program on 100,000 Medicare participants in South Carolina. To run the implementation, CMS is working with Gaithersburg, MD-based IT contractor QSSI, which will important two years' worth of Medicare claims data into a commercial PHR system from HealthTrio. As part of the rollout, CMS plans to run a large campaign not only to convince beneficiaries to participate, but also to get community providers to make use of the new PHR option. Over time, CMS plans to study the results from this and other previous PHR projects to examine whether patients and providers made use of the PHRs and how easy they were to use, among other factors.

To find out more about the project:
- read this Government Health IT piece

Related Articles:
You tell me: What's a PHR? Editorial
Microsoft kicks off PHR initiative. Report
AHIMA promotes PHR use. Report
Giant employers move ahead with PHR project. Report
A PHR turning point. Editorial