Personal health models prevail on Web as plans ponder platform strategies

NATIONAL REPORTS-As more health information becomes available in electronic formats, it is not surprising that companies such as Google, Microsoft and Revolution Health Group have latched on to this business opportunity in the form of personal health records (PHRs).

According to Steve Gravely, partner and head of the healthcare practice group at law firm Troutman Sanders in Richmond, Va., and co-chair of HHS's Data Use and Reciprocal Support Agreement Workgroup, it's become more feasible and more necessary to integrate health information into a single source.

"It is not surprising that companies who already are in the business of managing large amounts of data would enter this space," Gravely says. "This is important for managed care executives because, historically, managed care plans have been the primary place in which health information was aggregated into one location. This will change as more and more players enter this space. The impact on managed care plans is very unclear."

"Access to information is critical to driving behavior change, and we view this as the essential lever in transforming the health system," Dr. Schmuland says.

Microsoft's HealthVault allows users to gather, store and share health information online and control their records so they can privately share information with family and healthcare professionals. Dr. Schmuland believes PHRs fit with the consumer-centric, self-service model prevalent throughout the Web.

Aetna is exploring relationships in the online health IT space. Its claims-driven CareEngine PHR provides members with online access to personal health-related information. According to spokesperson Elizabeth Sell, Aetna is in exploratory discussions with Google to collaborate around the Google Health platform.

In addition, ActiveHealth Management, a subsidiary of Aetna, is providing a version of its PHR directly to consumers via HealthVault. Also in keeping with this trend, Aetna and Healthline Networks recently introduced SmartSource, a member health search engine that also includes benefit information tailored to the individual.

PHR POTENTIAL

Having medical records available in a PHR that they control could also entice consumers to seek more second opinions and specialist consultations.

"By not having to go through their primary care physician for a copy of records, consumers may feel more empowered to seek out these other providers," Gravely says.

Knowing what it costs to launch and maintain electronic personal health records, Alan Abramson, HealthPartners' senior vice president and chief information officer for IS, wonders who will foot the bill to make these new offerings economically sustainable.

"When it becomes more clear who will provide the sustaining revenue, it will perhaps become more clear what pressures will be applied to the use of data in these records," Abramson says.

However, he sees enormous benefit to be gained from members becoming actively engaged in managing their own health. In the meantime, payers and providers will have to slowly separate PHRs' true potential from the imagined potential.

Grad Conn, senior director, product marketing, Microsoft Health Solutions Group, plays out several scenarios that HealthVault and similar platforms can address. "Imagine not having to fill out the same info each time during the admission process," Conn says. "Imagine authorizing a physicians' clinical systems access to a patient's complete medical history, whether it's a primary caregiver, specialist referral, an emergency room visit or a new physician seen while traveling. Right now, your lab tests either never reach you, or only in paper form."

Whether consumers will trust their PHR vendor is very much a function of the control consumers believe they have over the data. "Initially, consumers may be skeptical about how the data in their PHR might be used and who will have access to it," Gravely says. "Consumers want control of their health information. If they believe that PHRs will give them that control, then I believe they will develop trust in the PHR and use it more fully."