Personal health records Featured

7:00pm EDT November 25, 2007

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