The nation’s health insurance companies, representing 200
million Americans, announced a plan December 13 to create a standardized digital
health record that can be owned by members even if they switch insurance
carriers.
The announcement comes amid a series of high-profile
developments in the effort to reduce health care costs paid by employers and to
create products focused on the needs of individual health care consumers.
Washington, D.C., on the subject of digital health
records.
But health care experts caution that these initial milestones
and spikes in public awareness are baby steps. The industry is far from being
able to deliver the improved quality of care and cost savings that is promised
with personal health records.
“This might be a first step to get us there, but as a
stand-alone activity it has little value,” says Gerard Anderson, director of the
Center for Hospital Finance and Management at the Johns Hopkins Bloomberg School
of Public Health.
That first step,
announced jointly by America’s Health Insurance Plans and
the Blue Cross Blue Shield Associations, would create a standard personal health
record that could be used by all health plans. At a minimum, the group says, the
standards would include: patient information, doctors visits, medications, lab
results, providers, facilities, subscriber information, benefit information,
family history, physiological information, immunizations, health risk factors,
advance directives, alerts (including allergies) and plan of care.
“We felt that because so much of the information for people
to have a health record is based on claims filed, we were able to make this
available in the short term,” AHIP spokeswoman Susan Pisano says. The plan was
also supported by the National Health Council, a
nonprofit whose members include health associations such as the American Cancer
Society and the Lance Armstrong Foundation.
Pisano says that because of their size, health insurance
companies are better equipped than employers to lead the development of personal
health records.
“We also realize that more than 200 million people get their
coverage through BCBS or AHIP,” Pisano says. “That gives us substantial reach;
that gives us two-thirds of America.”
But unless that information can include the kinds of
diagnostic detail doctors use to treat patients, the record will not improve
health care quality or avoid unnecessary or redundant procedures, Anderson says.
Still, it makes sense to
have health insurance companies and employers pay for the effort to develop
personal health records, as they will benefit from the cost savings and improved
health of insured employees, says Keith Strier, a senior manager in the life
sciences and health care practice at Deloitte. And no one else is likely to foot
the bill. Anderson says $156 billion in capital
investments will be needed over a five-year period to create a national health
IT network, of which personal health records would be a component.
Strier sees the decision
to create an interoperable health record as a sign of positive cooperation among
health insurance companies. The companies, he says, are in a better position
than employers to use their product design capabilities to create an
interoperable personal health record and bring it to market.
But whether the product
comes from employers or health insurers, the goal is the same: to improve the
health care of individuals and reduce costs for the employers footing the bill.
Health IT experts say the personal health record is at the center of that kind
of transformation.
“The proactivity of large employers and major payers
signifies the kind of momentum we need in order to drive better outcomes in
health care,” Strier says. “And that is not going to happen until [consumers]
get more involved, and the personal health record is a main way to make that
happen.”
—Jeremy Smerd