March 10, 2009
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A PHR is a centralized place for people to electronically store and organize their personal health information, separate from electronic or paper medical records maintained by their health care providers. Many advocates believe that PHRs have the potential to revolutionize health care by engaging patients in their care, improving patient-clinician communication, and, ultimately, improving health outcomes and reducing costs.
While there are many different types of PHRs, including stand-alone and provider-sponsored products, the study focuses on PHRs offered by health insurers. Typically, health insurers automatically fill PHRs with medical and pharmacy claims data and allow patients to enter additional information. Some insurers offer features to facilitate data sharing with physicians via the PHR or through a separate portal of claims-based records.
Health insurer PHRs are relatively new, and the evolving products vary greatly in design. Many insurers initially offered a basic PHR in response to employers demands. Nonetheless, nearly all the insurers in the study were enhancing their PHR offerings, primarily as a competitive strategy. For example, in addition to claims-based information, insurers are adding selected laboratory results and care management applications, such as clinical alerts and reminders and identification of patients for disease management programs.
Insurers ability to put claims-based data into PHRs was seen as an advantage, but consumer representatives suggested that enrollees concerns about data security and confidentiality could hamper adoption, while physicians question the use of claims data for treatment purposes and have concerns about incorporating use of PHR information into practice workflows.
"To date, most insurers havent actively marketed PHRs to enrollees and physicians, and patient take up and physician awareness of insurer-sponsored PHRs appears to be low," said Joy M. Grossman, Ph.D., HSC senior researcher and coauthor of the study with Teresa Zayas-Cabán, senior manager of health information technology at the Agency for Healthcare Research and Quality; and Nicole Kemper, M.P.H, an HSC health research analyst. HSC is a nonpartisan health policy research organization funded in part by the Robert Wood Johnson Foundation, which funded the study.
The Health Affairs article, titled "Information Gap: Can Health Insurer Personal Health Records Meet Patients and Physicians Needs," is based on 35 interviews conducted in July and August 2008 with executives at health insurers offering PHRs, consumer representatives, physicians, PHR experts and insurance trade associations.
Key study findings include the following:
According to the study, public and private payers could consider various strategies
to reduce barriers to PHR use, including: (1) developing clear, understandable
privacy policies, for example, specifying how the data will and will not be
used; (2) providing real-time audit tools that allow enrollees to identify who
has accessed the PHR; (3) supporting portability of PHR data to patient-controlled
data platforms and applications; and (4) developing unique insurer-specific
tools to help enrollees navigate the health care system, understand insurance
benefits and manage out-of-pocket costs.
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.