Can We Build The Goodies (PHR)?

I am sitting in on a discussion around PHRs and Consumer Connectivity which features Jeffrey Gruen (Chief Medical Officer at Revolution Health) and Jeffery Rideout (Chief Medical Officer from Health Evolution Partners).

Let’s start with utilization – only 10% of people have access to a PHR (Personal Health Record) through their plan and only about 2% actually use it (at best).  This brings three challenges to the table: (1) building awareness; (2) security and trust and (3) automating the data load.  The next question is can you make these fun and engaging tools (i.e., the goodies).

The presenters and the facilitator who is from Carol all start with a fairly skeptical view of the world.  They pointed out that it’s like an ink test…everyone sees something different.

It seems to be a big challenge.  Do you build it for what everyone wants which would be a laundry list or do you build it for what you think they want which generalizes?  I do agree that systemically the value is collecting and tracking data that can be shared with your care team across providers and insurers.

I must admit that some of the things that I would want include:

  1. Claims access (lab, medical, pharmacy)
  2. Tracking of OTCs (pulled from my savings accounts)
  3. Current benefit information (which assumes it is transferable across payors)
  4. Disease information
  5. A communication hub for sending and receiving secure messages
  6. Outbound reminders to me about events or opportunities
  7. Identification of care opportunities
  8. Tracking of information
  9. Integration of health social networks
  10. Recommendations of things to do or act upon

But, like I would consult any sales person, why are we talking functionality and features versus value.  From a value perspective, I want a safe, proactive application that helps me become healthier.  Not an easy request.  If I track my running, can it tell me that I am adding miles too fast?  Can it tell me about a drug-drug interaction?  Can it tell me that I paid too much for a treatment?  Can it track my total spend?  Can it help me predict comorbities based on data and possibly even my genomics information?

One of the members of the audience chimed in (rather passionately) that no one wants a PHR from a payor or stand-alone company.  The majority want it from the physician.  [An opinion of one, but I don’t and can’t imagine getting anything from my physician.  Maybe I don’t have the right relationship or the right chronic diseases, but I move and I want to have the choice to find the best doctor and not feel stickiness to them.]

Here’s a couple of presentations on this:

I didn’t realize until yesterday that for the DTC (direct-to-consumer) PHRs that are available the consumer has to actually enter all their own data.  It isn’t automated.  What a potential nightmare.

So, a real couple of questions are:

  • Who is this for – patient, providers, payors, care team?
  • Why would I ever spend anytime on a PHR if I couldn’t transfer it to my next payor?  I think this makes a play for Google and Microsoft and Dossia to provide a backbone that all the other PHRs use to create interoperability.

One Response to “Can We Build The Goodies (PHR)?”

  1. Hi George,

    I’ve noticed in a couple of your posts that you seem to have a bias toward payor provided PHRs. I’m in agreement wtih the audience member — my preference would be to get teh _data_ from my provider(s) and have it posted to a PHR (maybe HealthVault, maybe Google, maybe something else). Just as you might want to change your provider, I might want to change insurer and then where am I?
    We all need to be thinking about making data accessible and not tying it to a PHR vendor, whether that vendor is a provider, a payer, or some 3rd party commercial entity.

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