An interesting session on personal health records…with a Taiwanese and Silicon Valley flavor……..

Taiwan has a single payer system, with some copay. Was 41% uninsured, and then March 1 1995 went to 92% coverage, now it’s universal. Have a standardized IT system, and as a single payer can profile doctors, hospitals and even more granular.  Moved to smart cards in 2001. moving to a PACS system within a year or two and want to have full EMR 2008.

Care is so good that 80% of Taiwanese would go back home if they were in China even for acute appendicitis.

There are some doctor shoppers. One war veteran had 1543 visits per year, by taking his Rx back to his home village in China.  Plenty of waste in the system, and lack of continuity of care. So they used 2 approaches to rein in consumers. One is IT, the other is P4P. Took 5 procedures/diseases for P4P and are seeing changes. Smart cards are the other approach. Spent less than $200 million  for all the 23m Taiwanese smart card. Good tool for moving to electronic health records.—card holds some information but also acts as an access key via reader. Links to other information in the doctors office. Some

Scott Cook, Intuit

Thinks that health care is complex, but taxes are too! Replaces complexity with Turbo tax, which hides (allegedly) the complexity behind a questionnaire. But now brings in the information from banks, payroll providers, mutual funds, etc. Now 21m using Turbotax. Those customers are loyal, so many institutions embed that in their links

Quicken has simplified financial life. Now 15m households use quicken, connecting to back end financial institutions.

What caused these high levels of consumer adoption? Attention to the customer?  Study them carefully. Deck the halls with findings of customers. Do lots of P&G type follow up, Cook learned his trade at P&G and it shows.

Now they’re moving into health care. I asked Scott who he thought his biggest competitors in the PHR business would be. But he didn’t want to answer…but I suspect that WebMD is at least somewhere on that list. Intuit has agreements with Ingenix, Sentara and various other players.  Expect a product launch next year. Few details but think about a version of Quicken that integrates claims the way that Quicken integrates banking info (my guess).

But no question that they’re going to be a major player.