Mobilizing Personal Health Information - Consumer Perspective

How will consumers "mobilize" their personal health information?

On July 29, the American Health Information Community (AHIC, "The Community") examined how consumers may access, use and share their personal health information (PHI). This article highlights the consumer perspective.

Utility Service Model

John Moore from Chilmark Research compared several business models for PHI delivery. These include: 1) Consumer approach to manage health, 2) Employer and healthplan approach to reduce costs and manage risks, 3) Provider approach for consumer (patient) retention, and 4) Utility service model approach to "create an ecosystem".

The utility service model consolidates multiple data sources into a secure repository available to multiple applications and services. This model scores very well, with the notable exception of portability which is "under development". Moore scored the utility service model as the only approach with the potential for high rates of adoption.

Consumer Interest

Carol Diamond of Markle Foundation's Connecting for Health organization surveyed public attitudes towards Personal Health Records (PHR). Markle's survey found only 13.5% of respondents very interested in using a free web-based PHR and another third somewhat interested.

Markle contends that the establishment of privacy and information practices are critical to consumer PHR adoption.



















Markle's Connecting for Health Common Framework and Framework for Networked Personal Health Information define clear "price of admission" requirements for PHR adoption, but are they sufficient to achieve adoption?

Standards and Interoperability
Connectivity with healthcare organizations will be required to make PHR's easy to access and manage. Jeff Blair, Lovelace Clinic, made the case for the Nationwide Health Information Network and standards based interoperability as foundational elements to achieve adoption.

Editorial comment: Where are the incentives?
The one missing ingredient in all of this: financial incentives for patients and providers. Why are payers and employers more interested in PHR adoption? They are dealing with the pocketbook issues of how population health affects their P&L.

Making Sense of National Healthcare IT

Avance Health Analysis

Recent news of HITSP's submissions to The Community (AHIC) June meeting, prompted a reader to ask: How do the various national healthcare initiatives (AHIC, HITSP, HHS, CCHIT and NHIN) fit together?

Is the relationship between these organizations Rube Goldberg-esque? Or is there some more coherent design?



The mission of American Health Information Community ("The Community" or AHIC) is to provide "input and recommendations to the Department of Health and Human Services (HHS) on how to make health records digital and interoperable, and assure that the privacy and security of those records are protected in a smooth, market-led way." AHIC is presently reorganizing itself to ensure its viability beyond the term of the current administration, by establishing "AHIC 2.0" as a sustainable public-private organization. AHIC is the focal point for guidance to HHS on priorities for interoperability and develops the use cases for these priorities.

The Healthcare Information Technology Standards Panel (HITSP) mission is to "harmonize and integrate standards that will meet clinical and business needs for sharing information among organizations and systems." HITSP takes its guidance on priorities and use case definition from AHIC and proposes standards (like those to be presented today at the AHIC June 2008 meeting) to the HHS Secretary.

The HHS Secretary can accept the recommendations which starts the clock on a one year cycle of testing and implementation. At the end of this cycle, the HHS Secretary can choose to "recognize" these standards. Once standards are recognized, by Executive Order, they are incorporated into new Federal Systems and Healthcare Contracts.

Recognition of these standards also serves as input to the Certification Commission for Healthcare Information Technology (CCHIT). CCHIT is a recognized certification body (RCB) for Electronic Health Records (EHR) with the goal of accelerating EHR adoption. CCHIT establishes its roadmap and criteria for Electronic Health Records based in part on the recognized standards from the HHS Secretary.

These recognized interoperability standards are also incorporated by the Nationwide Health Information Network (NHIN), a network of networks promoting Health Information Exchange.