Tuesday, November 18, 2008

A Milestone for Personal Health Records

On November 12, Acting CMS administrator Kerry Weems and HHS Secretary Michael Leavitt made an announcement that has not been widely covered in the press, yet has deep significance.

The Center for Medicare and Medicaid Services (CMS) has embraced personal health records and will enable Medicare members in Arizona and Utah to access their own data from CMS databases via Google Health , NoMoreClipBoard , HealthTrio , and PassportMD . CMS pushes the data to the beneficiary's personal health record account upon the request of the beneficiary, rather than giving PHR vendors direct access to CMS databases.

Having worked with CMS for many years on transactions for treament/payment/operations and having worked with the CMS contracted Research Data Assistance Center (ResDac) for research datasets, I can say that CMS is very conservative about sharing its data and embracing new technologies.

The fact that CMS has linked the Medicare database to Google Health and other PHRs implies that CMS has embraced Healthcare 2.0 approaches to infrastructure and has validated the importance of personal health records. It also signifies that CMS has accepted secure transmission of healthcare data over the internet using HTTPS as secure enough. In the past, it's been challenging to transmit data from/to CMS via the public internet.

CMS, the funder of more than half of the healthcare in the US, generally drives adoption and change through reimbursement policy. In this case, by offering patients access to their own claims data, CMS will create patient expectations that will motivate the private payer community to do the same.

Linking Medicare over the internet to PHRs may be one of Secretary Leavitt's greatest accomplishments. Let's hope the Arizona and Utah pilots are successful.


Johnnysmooth said...

Yes John, agree with you that it is good to see CMS begin experimenting with the use of PHRs by beneficiaries, but note, that this is not the first time. For over a year now, they have been conducting a similar demonstration in South Carolina with Healthtrio, who just happens to be one of the "winners" of the AZ/UT demo.

And I use the term winners lightly as CMS has put absolutely no $$$ into the AZ/UT demo - all costs are to be covered by the PHR vendors. Sure, the PHR vendors will get some publicity, but am troubled that CMS does not see enough value to put their money where their mouth is.

Sachi said...

This is indeed a remarkable achievement by CMS!

I was curious as to your views on universal IDs like the Voluntary Universal Healthcare Identification (VUHID) system, and their applicability in PHRs and HIEs.

TechScribbler said...

There were earlier stories about this.

See http://www.govhealthit.com/online/news/350508-1.html

Medical Quack said...

I post quite a bit about both Google Health and the MS HealthVault, almost of late where the blog is beginning to resemble a PHR blog, but it's not. I also would like to see some outreach programs to help the seniors with the PHR pilot programs.

My 84 year old mother in AZ does fine with hers but helped her a little to set it up, so someone along the line somewhere has to help get people started.

I agree too that hopefully we are over the bump about security here too as who provides and helps protect the enterprise, none other than Google and Microsoft.

I particularly like the TrialX for clinical trials as an add on to locate trials quickly and eventually with an API it could be brought down to the point of care with an EHR to include alerts, and even integrated with more sophisticated research systems if the need was there.

On the HealthVault I signed up for the $9.00 a year free incoming fax number so if I am in a "low tech MD office" with a fax only, it can still go direct to the vault, and shoot I could send my grocery list there too if I wanted:)

Somewhere along the line there needs to be something done in the education portion though as I walk in to doctor's offices that have no clue what a PHR is and the value of helping prevent medical errors too.

Until we have systems all connected and talking to each other, the PHRs are the way to to go to get credible medical information in the hands of clinicians who need it to diagnose and treat. Have one ER physician who is a believer now and the post made it up to Reuters, good one to see his formulas used!


Here's a general search on my site link on PHRs, there's quite a few graphics and you might find yourself mentioned I believe a couple times within the posts.


Hopefully if enough keep talking it up on the web perhaps it will take hold. I keep advising those folks who want to just talk about PHRs and ask questions to go sign up for one and get started, that's the best way to see how the a PHR works and the power to share information.

I just hate to see software capabilities just somewhat thrown out there without education and some kind of instruction as it loses so much of the impact and usefulness that could be taken advantage of.

Unknown said...

This is a good market for GE and others; electronic medical records can increase efficiency and only about 10% - 15% of hospitals -- and about the same percent of doctors -- have adopted EMR systems.

What’s tougher is the big price tag: Will electronic records really decrease healthcare costs? We know there will be a spike in costs at the outset, and that the systems are likely to cost more than anticipated. The ROI is still unclear.

Even trickier is the underlying logic of these systems, especially around the need to assure and deliver quality, consistent care. Do they incorporate the smartest diagnostic and quality care guidelines? Do they make evidence-based clinical information available at the bedside, along with the patient’s individual and historical information? Not all EMRs are created equal.

Possibilities? www.healthcaretownhall.com

Deborah said...

It will be interesting to watch events as they develop, but overall, this is good news!

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