In the push to make health care in the U.S. more efficient, digital personal health records are expected to play an important role. By giving patients control over their own digital records, it should be easier to maintain accurate information and avoid errors.
That’s the intent. But some doctors are less than enthusiastic about patient-managed records, fearing they could be inaccurate and incomplete.
The problems presented by paper records are widely understood. It’s nearly impossible to quickly gain access to important information held in paper records kept by different doctors and hospitals, particularly in emergencies. With electronic, patient-maintained personal health records, a patient could be admitted to an emergency room and his complete health record accessed instantly, at the direction of either the patient or the patient’s proxy.
“So many times people spend money, time or die because data is not shared,” said Colin Evans, CEO of Dossia, a nonprofit organization in Cambridge, Mass. Sponsored by large companies such as Wal-Mart Stores Inc. and Intel Corp., Dossia is promoting a personal health record system that its member companies are beginning to adopt for their employees. Dossia was founded by 10 large, self-insured employers, but the organization is aiming to make its service available to smaller employers in the future, according to Evans.
“We’re trying to figure out how to help employers deliver benefits to employees. What Dossia is attempting to become is a platform for launching wellness capabilities at large employers. It’s an area where employers and employees should agree -- keeping costs under control,” said Evans, who added that he has no illusions about the daunting task ahead. “Personal health care records are where the Internet was 15 years ago. They’re way behind.”
Dossia is one of three major players in the PHR arena. The others are Microsoft HealthVault and Google Health, both of which are free to consumers and built around business models that depend on advertising.
More than just individual well-being is tied up in the drive for electronic health records -- corporate competitiveness is also in play. According to a recent health care cost survey conducted by research firm Towers Perrin, companies that are high performers in their industries have found ways to significantly trim health care costs. The survey found high performers spend nearly $2,000 less per employee on health care than their low-performing peers.
One of the ways in which these companies gain an edge is through better use of technology, including the use of new applications like personal health records for employees. Stamford, Conn.-based Towers Perrin predicts the use of personal health record technology will double among high performers over the next few years, from 31% today to 60% in 2012.
It’s an area where employers and employees should agree -- keeping costs under control.
Colin Evans, CEO, Dossia
At Wal-Mart, employees who are on the giant retailer’s health plan can sign up for Dossia if they choose. About half of Wal-Mart’s employees are on the company’s health plan, according to Evans. Employees leaving the company can take their Dossia records with them.
Despite the apparent benefits of personal health records, some doctors balk at the notion of patient control. “A lot of doctors won’t use [personal health records] because patients can change the data,” Evans said, although he noted that without electronic records, patients routinely provide lots of information about themselves -- which may or may not be accurate -- whenever they check into a hospital.
With Dossia, participants can access their records with a user name and password. Patients can enter information about themselves and change it if necessary. However, they cannot change information that has been entered by a doctor or a hospital. A participant’s Social Security number is not linked to the record.
The Dossia user interface is designed around applets. Users can select the applets they want to see first, such as weight, cholesterol or fitness metrics. Future plans for Dossia include the ability to accept information from Bluetooth-enabled medical devices. In addition, Dossia technologists are working to enable Dossia information to be input -- as well as output -- to cell phones, according to Evans.
The drive for digital personal health records was first spurred by HIPAA, which gave patients the right to a copy of their health care record. The right to a digital health record was codified in the American Recovery and Reinvestment Act of 2009.
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