Are Privacy Standards Enough to Push Electronic Health Records?

Google, Microsoft, WebMD, Dossia and other major technology providers in the burgeoning PHR (personal health record) niche are all hopeful that a new privacy and security standard released last week will be just the catalyst they need to give consumers more control over their digital health care information.

Developed with direction from health care policy makers, insurers, consumer activists, health care providers and PHR technology vendors, the Connecting for Health Common Framework was the brainchild of The Markle Foundation. This New York-based non-profit organized the consensus framework through its public/private Connecting for Health collaborative group in the hopes that it could jumpstart the use of public health records among patients across America.

According to a survey also released by Markle last week, only about 2.7 percent of Americans currently take advantage of online personal health records, but 80 percent of those who use them find them extremely helpful.

Will the standard be enough to convince Joe Patient that PHR services are safe to use? And even if it is, can the PHR industry tackle the other technological challenges it needs to face to make widespread adoption a reality? Baseline takes out its stethoscope to examine the heart of the matter.

The PHR Ideal
An online PHR gives health care consumers the power to control all the data about their medical treatment, conditions and prescriptions in a single, portable digital file.

“PHRs are a way to give consumers more control over their own health care to help reap some of the benefits of health information exchange,” says Jim Dempsey, vice president for public policy of the Center for Democracy and Technology and a contributor to the Connecting for Health initiative. “They make it easier for patients to access their own health records to make those records available to providers.”

The idea has been around for some time, but only in the last several years has it begun to snowball, as employers looked for better ways to lower the cost of benefits and give their staff more medical choices. In fact, some large employers are so convinced that PHRs are a way of bringing health care costs down that they are taking drastic measures to make them a reality. Case in point: Intel, Wal-Mart, Pitney Bowes and BP teamed up to create a non-profit organization called Dossia to support member employees’ PHRs.

“The goal is to create the infrastructure that puts our employees’ health data in their hands,” says Colin Evans, president of Dossia. “We believe that empowering our employees to actually have data to become consumers will ultimately have the effect consumer pressure has in every other industry, to make it more efficient, more cost-effective and more effective, in general.”

Once member employees opt into the system, Dossia collects their information from their health plans, their health care providers, labs, pharmacies and so on, and offers digital access to the patient. The patients then have control over who sees their information. Not only can patients share their PHR with their regular physicians, they can also use them for a range of online health care applications and services that are cropping up to serve those with online PHRs.

“We have an open program interface that sits on top of Dossia which will enable a range of application service companies to provide tools that, with patient permission, can then be used on that data,” Evans says. “So an employer might do a deal with WebMD to provide a broad set of PHR tools, or they might have an arrangement with a disease-management company or a fitness company, or the employees themselves might hit the upgrade button and connect to services themselves. We’re an enabler of our employees, and we hope we’re talking to people on both ends of that food chain, the institutional data donors today as well as the software and application infrastructure.”

The last eight months have held breakthrough moments for PHR, as the two titans of computing, Microsoft and Google, both moved into the market with their own takes on health record services. In October 2007, Microsoft launched its HealthVault launch and Google followed suit in March Google Health

Despite all the early activity and hype surrounding PHRs, nobody’s using them yet.

“There are hundreds of companies that have personal health record systems, products, services [and] applications,” Evans says. “Every major health plan claims you can have access to your information personally. Most live providers give you access to their data. And yet almost none of these systems have any kind of volume adoption.”

Right now, Dossia’s users number in the hundreds, but the group is poised for a major rollout by summer’s end, which could potentially boost the total into the tens of thousands, Evans says.

Both Microsoft and Google are still in beta stages with their health services, and even players who have been around for awhile aren’t seeing huge numbers of consumers taking advantage of their services. Survey numbers and analyst estimates range from Markle’s 2 percent approximation to a generous guess from Forrester Research that PHRs have penetrated more than 6 percent of the U.S. population.