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TECH/HEALTH PLANS: Quick recap on PHRs and consumer health care

Yesterday I ran a panel at Teradata’s partner conference in MickeyMouseville, FL. On the panel were Liz Dudek from Medstat, Jill Burrington-Brown from AHIMA and David Cochran from Harvard Pilgrim health plan.

Pretty interesting conversation. David is particularly fun and funny. He thinks that consumers are being driven to the CDHP and have no real interest in it. Liz thinks that PHRs based on claims are going to be introduced by many more employers this fall. Jill is out educating anyone who listens about PHRs, but we all agreed that a unified consumer view of all their data is far away.

Funnily enough I was the most optimistic—I think that PHRs will be relatively common (15–20% uptake in 5–7 years?). Harris apparently said that it’s now 7% but I don’t believe that number. But after Wellpoint and United started providing it to their members

David had an interesting parsing out of the functions being lumped in a PHR

a) Communication transactions with physicians (appointment setting, refills, online visits)b) Information relevant to individuals health (Rx, Healthwise et al)—the Information therapy piecec) Financial transactions (EOB, related accounts)d) One other that I’ve forgotten!

His point is that not all organizations can do all pieces. The physician transaction piece is tough for a health plan, but is the most popular part of the PHRs run by Group Health, Caregroup, PAMF et al. So as in much of health care, expect spotty and varied implementation.

I agree, but I think that if the plans get serious about this it’ll force the providers to get involved. We shall see.

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LynnMatthew Holtdavesbd Recent comment authors
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Lynn
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Lynn

South Carolina’s new (improved?)proposed Medicaid Transformation Plan is built around a Medicaid beneficiary’s PHR. The PHR will be built around Medicaid’s claim data on the beneficiary. Enrollment counselors will “assist” the beneficiary in selecting the managed care plan that best meets his/her individual needs based on his/her PHR. I think this is a bit like having the DMV clerk tell you which car to buy based on your driving record. Providers will also have access to the Medicaid beneficiairy’s PHR. I’m still not sure how they coordinate this PHR with the current EMRs the practices may have in place. I’m… Read more »

Matthew Holt
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Matthew Holt

PHR is personal health record….if you search this site you’ll find that I’ve used that term many times
Emdeon sold Medical Manager recently–the WebMD PHR is sold to a completely different client set. So I am very unsure what you are going on about SBD.

SBD
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SBD

Take a look at Emdeon, the company that owns WebMD and the former Medical Manager and the secret VIPs service they offer to top clients. Early Warning Detection Our overpayment and fraud protection approach begins with Emdeon STARSentinel and its early-warning healthcare detection that can help identify duplicate claims, falsified procedure codes, false diagnosis codes, upcoding, over utilization of diagnostic procedures and a long list of other common fraud tactics. Emdeon STARSentinelâ„¢ – an automated, easy-to-use approach for detecting common fraud tactics, offering the following benefits: Reliable. Emdeon STARSentinel applies a rules-based methodology to call your attention to claims that… Read more »

SBD
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SBD

I think PHR is Personal Health Record.

dave
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dave

What’s a PHR?
A word to the wise – not every visitor to your site will automatically know all the vocabulary. Nothing more frustrating than finding a topic relevant website that is peppered with acronyms.
PHR Partnerships for Health Reform
PHR Parts per Hundred of Rubber
PHR Payroll, Human Resources
PHR Peak Heart Rate
PHR Performance Horse Registry, Inc.
PHR Personal Health Record
Phr Phrygian (linguistics)
PHR Physicians for Human Rights
PHR Potential Health Risk
PHR Preliminary Hazard Review
PHR Presse Hebdomadaire Régionale
PHR Profession of Human Resources
PHR Professional in Human Resources
PHR Public Health Region (Texas)
PHR Public Health Reports

sbd
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sbd

Aren’t all of these requirements available already by WebMD? Aren’t they also the parent company of Medical Manager? Maybe I am not understanding, but aren’t doctors and the major HMO’s already using this software for everything from Datamining, to using the sometimes unsubstantiated information from WebMD to deny claims? I always thought it was unethical to both make the billing and claims software which ties into the medical information you publish that may just happen to fit the plans needs. Almost forgot, wasn’t everyone at Medical Manager Corp recently indicted by the FBI for buying companies and then forcing the… Read more »