WASHINGTON President Bush, members of Congress, and key consumer organizations are all calling for the widespread implementation of electronic personal health recordsand now it is time to convince the public of their worth, David Lansky, Ph.D., said at a meeting on health information technology sponsored by eHealth Initiative and Bridges to Excellence.
Currently, most patients' health information is scattered across many different providers and facilities. Unlike physician- or institution-based electronic medical records, an electronic personal health record is maintained and updated by the patient, and can be vital to providing the patient the best medical care, especially in cases of an emergency.
Information such as health insurance policy numbers, health history, current medications and dosages, and allergies would be quickly accessible and could be shared among hospitals and providers, explained Dr. Lansky, senior director of health programs at the Markle Foundation, a nonprofit organization that is focused on accelerating the use of information technology in health care and national security.
Dr. Lansky mentioned several industries and organizations that have staked a high level of commitment to making this type of electronic collection commonplace:
▸ America's Health Insurance Plans and Blue Cross Blue Shield, whose member plans provide health insurance to more than 100 million Americans.
▸ Large employers, such as IBM Corp. and PepsiCo Inc.
▸ Consumer groups, including the AARP (formerly the American Association of Retired Persons) and the National Health Council.
▸ Internet companies such as Microsoft Corp., Google Inc., and WebMD Inc.
"This is a very exciting time," Dr. Lansky said. "Big companies see this year as the time to change how Americans view their health care."
However, although there are now many places consumers can go to develop an electronic personal health record (such as providers, employers, and pharmacies), they are not extremely popular.
For instance, he reported that so far, provider portals are used by "only about 15%20% of the patients to whom they are offered."
Most users are those who have both computer skills and a high use of the health care system, with frequent medical appointments or several prescription medications, Dr. Lansky said.
The one great challenge to implementing electronic personal health records nationwide is how to connect all the existing systems into one "national network" rather than what exists now: 13 or so different enterprises, each offering separate portals that aren't linked together.
A possible model, Dr. Lansky said, is a Web site that uses the type of network architecture that the health industry needs to mimic when creating a personal health record network. The site (www.flightstatus.com
Dr. Lansky said it was a good illustration of one way that different industries can share data.
"This is an example of where we would like to see the networked personal health record go," he said.
But the greatest challenge for the industry may be the issue of ensuring consumer privacy. Consumers, Dr. Lansky said, are leery about personal health records because they want to know exactly what is going to happen with their health data. And consumers aren't willing to give access to their health information to just anyone.
"Each study we've done shows that patients trust their doctor to handle their health record information," Dr. Lansky pointed out. "The challenge is to make patients understand that other parties play a role in their health care, and how we get them to expand their trust past their doctor. But I can say it's going to be tough."
One solution, Dr. Lansky said, is the idea of "consumer access services," which would play the role of a mediating body to facilitate consumers' access to the network. He explained that the mediating body would issue consumers' identity credentials and "vouch" for them as network users. It would also help consumers aggregate their personal health data and connect with various services.
Several groups, such as retail pharmacies and health plans, are prepared to offer the consumer access service.
"Lots of big players are entering this space to help solve these challenges," said Dr. Lansky. "The key to success is defining one consumer access service that is trusted by consumers. … This is critical to [our] meeting our goal."