Health Record Sites Compete To Keep Boomers' Secrets

October 19, 2008 at 04:00 PM
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Personal health records may be a product that boomer advisors should keep their eye on, experts say.

Today, boomer advisors could offer links to PHR systems on their own sites, write about the systems in client newsletters, or possibly post ads on PHR Web sites run by outside firms.

In the future, PHR systems and the applications linked to the systems could be a part of the insurance sales process.

A broker could, for example, set up a "high risk medical networking site" designed specifically for boomers with conditions such as diabetes who want health insurance, disability insurance or other protection products. The boomers could post anonymous, condensed versions of their medical records on the high risk medical networking site, and insurers could sift through the records to find individuals they were willing to insure.

Other insurers could use applications linked to PHR systems to sell discounted health or disability insurance to boomers who were willing to submit weekly weight and blood pressure readings through the Web.

Or PHR systems could continue to be something of an oddity.

The Bush administration has been an active supporter of PHR technology, and the Centers for Medicare and Medicaid Services will start a PHR pilot program for Medicare beneficiaries in January 2009. Both Sen. John McCain, R-Ariz., and Sen. Barack Obama, D-Ill., favor increased use of electronic health records by doctors and hospitals, and more use of PHRs by patients.

The Certification Commission for Healthcare Information Technology, Chicago, a body that accredits electronic health record systems for the U.S. Department of Health and Human Services, says health IT systems seeking accreditation this year must be able to export an electronic patient health summary.

Despite all of the support for PHR technology, researchers who in May conducted a survey of 1,580 U.S. adults commissioned by the Markle Foundation, Washington, found that only 3% of the survey participants now have PHRs.

About 46% of the participants said they would like a PHR, but the rest said they are not interested, and 57% of those who said they are not interested in PHRs cited worries about privacy as their top reason.

About 17% of the U.S. adults participating in an earlier survey, conducted in 2005 by Health Industry Insights, Framingham, Mass., said they had at least tried using PHR systems, and 27% of these reported that they had done so because they or relatives had experienced health care events that showed them the importance of having medical records available.

This year, companies are making major efforts to expand use of PHR technology.

Microsoft Corp., Redmond, Wash., has introduced a test version of the HealthVault system, a free, Web-based health record storage and sharing system.

Google Inc., Mountain View, Calif., followed in May by introducing a test version of its own Google Health record and sharing system.

A third organization, Omnimedix Institute, Portland, Ore., recently unveiled a test version of another health record storage system, Dossia. Dossia is backed by an employer consortium, and Wal-Mart Stores, Bentonville, Ark., will be offering the Dossia system to all employees in 2009.

Aetna Inc., Hartford, and other health insurers are starting to roll out their own PHR systems that, with a patient's consent, can populate a PHR with information based on claims records at the click of a button.

The creators of many of the systems are developing arrangements that outside vendors can use to give or sell services to the PHR system users.

Google, for example, offers access to the MyMedicalSummary and the yourHealth by UNIVAL services for users who need help entering records into Google Health, and it offers access to MediConnect Global Inc., Salt Lake City, for users who need help getting the records.

Aetna works on supplementing information based on claims data and lab results by persuading users to enter more information, such as family history, and it also has a system that can send members personalized advice and invitations to join condition management programs based on the information entered, according to Dan Greden, a senior director at Aetna.

Privacy concerns could be a significant barrier to PHR use among boomers who grew up reading books and watching movies about Big Brother.

If the PHR system developers succeed at easing privacy concerns, the systems should be a natural fit for boomers who are starting to develop health problems.

At Aetna, for example, the PHR system seems to be especially popular with members who are boomers, Greden says.

Only 16% of Aetna members have chronic health conditions such as high blood pressure and high cholesterol levels, but about 36% of the Aetna PHR users have chronic conditions, Greden says.

When members do set up PHRs with Aetna, "they're not just one-time users," Greden says. "Once they've exported to the PHR, they come back pretty frequently."

Greden says he also sees growing awareness of PHR systems among health plan sponsors and benefits advisors. "We've got strong demand from the broker community," Greden says.

At this point, none of the major PHR system providers has an application that can pitch a user's medical history to insurers, or to life settlement companies.

But Aviva Life and Annuity Company, Des Moines, Iowa, a unit of Aviva P.L.C., London, already has a Wellness for Life program that offers lower rates for insureds who get regular checkups, and even lower rates for insureds who maintain their body weight within a specified range.

The Aviva program relies on examinations by doctors. But the Microsoft HealthVault system provides links to companies that sell scales that can transmit weight readings into the HealthVault PHR system through the Internet. The site also gives links to sellers of devices that can feed data about blood glucose readings, blood pressure readings, blood oxygen levels into the PHR system.

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