According to the American Health
Information Management Association, keeping a personal health record (PHR) allows a person to provide
doctors with valuable information that can
help improve the quality of care he or she
receives; can help reduce or eliminate
duplicate tests and allow a person to
receive faster, safer treatment and care in
an emergency; and helps people play a
more active role in their health care.
There are numerous ways consumers
can compile PHRs; many resources are
available in the marketplace. In addition,
several plan providers offer tools for members through the plan’s Web site.
Smart Business asked John Higbee, vice
president, CIO and CSSO, AvMed Health
Plans, how employees can go about compiling a PHR and why they would be
inclined to do so.
What is the difference between a personal
health record and an electronic medical
record (EMR)?
An EMR is the record you would find at a
hospital or physician’s office. A PHR is a
record compiled by the health care consumer. Some health plan providers offer a
service where members can go to a Web
site to create a PHR. Up to this point, adoption of EMRs by physicians has been spotty, perhaps around 20 to 30 percent. They
are costly to implement and physicians’
offices are typically not fast to adapt to
changes in office technology. The widespread use of EMRs will take quite some
time. The Centers for Medicare and
Medicaid Services (CMS) is offering seed
money to practices to adopt EMRs.
Hospitals are ahead of the curve. Many are
already using or are preparing to use
EMRs.
What type of information does a plan-sponsored PHR contain?
In addition to what a person would manually input about his or her history, the
information present would generally be
limited to claims information received by
the providers. If there have been gaps in health care coverage, there will be gaps in
the record, as well. For instance, if someone was between jobs and without coverage or had coverage with another plan
before becoming covered under a new
provider and during that time had lab work
done, the results of the lab tests would be
in the EMR, but rarely would show up in
the PHR.
How does a person go about setting up his or
her plan-sponsored PHR?
He or she would go online and fill out a
health history answering basic questions
and inputting information about any medications he or she is on, chronic conditions,
etc. The system is secure and requires a
user ID and password.
What are the benefits of PHRs to employers
and their employees?
For employers, more responsibility shifts
to employees for being engaged in their
health care. With higher premiums and
high-deductible plans a concern, employees become more conscious and have
more incentive to live a healthier lifestyle.
PHRs are designed to help members make better health decisions. Part of the premise
is that the person can avoid filling out the
same forms every time he or she seeks
medical care. The goal is to provide convenience and a place to record details.
Users are encouraged to print out a copy of
their PHR, as well, so it is available in the
event of an emergency.
How can employees be encouraged to compile a PHR at the health plan’s Web site?
After an employee has gone through the
process of identifying his or her medical
conditions online, the system can be set up
so that the health plan sends the employee
educational information about his or her
specific condition. This provides a good
way to get information flowing back and
forth. The challenge is to keep the person
engaged over time. Incentives may be
offered. The content of the plan itself may
encourage employees to take better care of
themselves [e.g., high deductibles], but
motivation comes highly from the individual. Employers have a vested interest in
keeping employees healthy [less sick days,
lower premiums, etc.], yet very few are
willing to assign higher premiums to
employees who do not adapt healthy
lifestyles. We’re seeing some of this, but in
general, health care is still wrapped up as
an employee benefit in this country.
What does the future hold for PHRs?
There is a fast-growing market for health
care information technology. With companies such as Intuit and Microsoft entering
the business, we should see a great deal of
acceleration. There is an increasing
amount of money being invested in the
technology, which is good for hospitals,
physicians, health plans and employers
because fast access to comprehensive
information is in the best interests of all
health care consumers.
JOHN HIGBEE is vice president, CIO and CSSO for AvMed
Health Plans. Reach him at (305) 671-0109 or
[email protected].
