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TECH: PHRs for health plan members…maybe, maybe

And in the bitter, twisted segment of THCB this week, apparently Empire Blues will be offering personal health records to their patients. And the records will be prepopulated for the members with information gleaned from claims data. including outpatient lab test results, physician visits, hospital stays, reported diagnoses and prescriptions. They can also (self-enter, I assume) values, such as cholesterol levels, that can be grouped together and graphically tracked over time. They’re using WebMD (who bought Wellmed, the last man standing in the PHR space phase 1 c.2002) to provide the service.

This is a screamingly logical thing for health plans to do. It gives them a compelling front end web application for their members, and thus gives their members a reason to stick with the plan (given the choice, although I know a lot of members are not). In addition they are the only ones who’ve got the majority of a member’s data all in one place. The only real exceptions are providers with a full service HMO like a Kaiser or a Group Health of Puget Sound who can then offer views into their electronic medical record system (e.g. MyEpic). For the traditional health plans, who’s CRM for their members has been completely crap for decades, this is an easy and relatively cheap way to improve their "customer service".

I’m just a little bitter that they’ve decided to do it now rather than FIVE years ago when I was selling exactly the same thing….

However, if any health plan or tech company wants to know more about this, I will work for food.

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Stephanie Siegrist, MDBrian KlepperMatthew HoltSue Recent comment authors
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Stephanie Siegrist, MD
Guest

It’s only a matter of time before the underwriters or nurse interviewers gain access to your supermarket shoppers card/credit card data to find you’re gobbling nachos despite your $150/month Prevacid prescription, diabetes and last year’s cardiac bypass. That aside, it’s about time the payors used the information at their fingertips (the claims data) to help their policyholders and the doctors who treat them. Why should patients have to sit in my waiting room with a clipboard, filling out their past medical history, allergies and medication list. Their insurance company could minimize errors from poor memories or literacy skills by forwarding… Read more »

Matthew Holt
Guest

Brian — It’s worth knowing that for example First Health Inc and AdvancePCS bought a version of an online health record in 2001 from my company — and never deployed it. So the technology has been around for FIVE years The fact thatso few have one in place — and that Group Health of Puget sound is trumpeting it in their advertising – reflects the crappy regard in which health plans hold their members

Brian Klepper
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Brian Klepper

Its worth knowing that several other plans around the country have had similar approaches in place for awhile, though the larger plans have taken longer to adopt this technology. A 320,000 life coalition in Las Vegas – comprised of hotels and food service workers in Las Vegas – has had a similar system underway for a couple years, using Worlddoc under the direction of Jerry Reeves, MD. Dr. Reeves is a former national Medical Director for Humana. Worlddoc is a patient-decision support tool that also creates an individualized online health record that incorporates claims information as well as self-reported information… Read more »

Sue
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Sue

Matthew this is the part that gets tricky and I’m going to quote from the reference you gave: “Members can access the software from a secure Web site to enter and maintain such records as medical histories, health risks and allergies.” Obviously some of that data will be documented in medical records and that data should be legitimately documented–but if individuals like this feature enough to enter medical data they learn from family histories, etc. they may add to their risk rating without understanding the implications. As an example, let’s say a woman participating in this program starts updating her… Read more »

Matthew Holt
Guest

Yeah, but I’m referring here to the information about you that the plan has already got being presented back to you NOT you giving more information than you want to.
Agreed though that we need a system in which your fears are removed by strong legislation against underwriting.

Sue
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Sue

While conceptually that is a great idea that long-term could benefit people and health care professionals, as the “victim” of aggressive underwriting, I can tell you my current policy is “don’t ask, don’t tell.” I will disclose what I am legally require to disclose but I’m not providing any information voluntarily that isn’t absolutely required as part of plan. I recognize that claims data will get added, but I would not voluntarily expand that database by adding information the insurance company would not otherwise see. My new insurer provides the benefit of a nurse who will fill out a health… Read more »