Comments on: My Health Plan PHR Experience http://ixcenterblog.org/archives/272 Engaging consumers with information therapy (Ix) and HIT Thu, 04 Dec 2008 21:36:49 +0000 http://wordpress.org/?v=2.3.3 By: Health 2.0 PCHIT: Social Networks and Cancer Care | Patient Centered Health Information Technology (PCHIT) http://ixcenterblog.org/archives/272#comment-106 Health 2.0 PCHIT: Social Networks and Cancer Care | Patient Centered Health Information Technology (PCHIT) Fri, 25 Jan 2008 19:39:44 +0000 http://ixcenterblog.org/archives/272#comment-106 [...] The time we’ve been spending in the exam room shadowing clinicians and patients has been invaluable. But it’s also important that we observe how consumers are using HIT applications in their homes–after all, for most people, more than 99% of the time they are outside of traditional care delivery settings. For that reason, we have done things like shadowing consumers using PHRs in their homes and described our own experiences in using PHRs. [...] […] The time we’ve been spending in the exam room shadowing clinicians and patients has been invaluable. But it’s also important that we observe how consumers are using HIT applications in their homes–after all, for most people, more than 99% of the time they are outside of traditional care delivery settings. For that reason, we have done things like shadowing consumers using PHRs in their homes and described our own experiences in using PHRs. […]

]]> By: Dorothy http://ixcenterblog.org/archives/272#comment-107 Dorothy Thu, 17 Jan 2008 17:20:59 +0000 http://ixcenterblog.org/archives/272#comment-107 Hard not to feel some sympathy for health plans…at least those reporting HEDIS performance measures for accreditation by NCQA. They are accountable for the quality/effectiveness of care delivered by independent physicians who are often overburdened by multiple relationships with other plans and are still in many cases resistant to the concept of rating outcomes or performance. Plans scramble to come up with interventions to improve HEDIS scores at the physician level (P4P, care reminder/alert letters, updates on clinical quidelines, etc). Physicians frequently respond with indifference and/or frustration and often shift responsibility for better health outcomes to issues with patient compliance. So in what appears to be a logical step, plans develop interventions to connect directly with “members” to influence quality, health behaviors and provide support for chronic care management in particular. (other motives such as market share/competition are involved of course) PHRs, Health Risk Appraisals, screening reminders, etc are some of the tools that plans might employ to influence patient compliance and improve health outcomes and risk reduction. Personally I am more concerned about the overuse, underuse and misuse of health care that could be caught through EHRs and the potential benefits for continuity of care across time and across providers offered by interoperable EHRs than building a personal electronic repository for my health care records/concerns/behaviors. But agree with JGO that I would encourage plans to devote scarce financial resources to physicians…just not toss into their pockets but to reward practices for EHR adoption and to support physicians that are actively using patient centered HIT systems to truly improve quality and effectiveness of care. Hard not to feel some sympathy for health plans…at least those reporting HEDIS performance measures for accreditation by NCQA. They are accountable for the quality/effectiveness of care delivered by independent physicians who are often overburdened by multiple relationships with other plans and are still in many cases resistant to the concept of rating outcomes or performance. Plans scramble to come up with interventions to improve HEDIS scores at the physician level (P4P, care reminder/alert letters, updates on clinical quidelines, etc). Physicians frequently respond with indifference and/or frustration and often shift responsibility for better health outcomes to issues with patient compliance. So in what appears to be a logical step, plans develop interventions to connect directly with “members” to influence quality, health behaviors and provide support for chronic care management in particular. (other motives such as market share/competition are involved of course) PHRs, Health Risk Appraisals, screening reminders, etc are some of the tools that plans might employ to influence patient compliance and improve health outcomes and risk reduction.

Personally I am more concerned about the overuse, underuse and misuse of health care that could be caught through EHRs and the potential benefits for continuity of care across time and across providers offered by interoperable EHRs than building a personal electronic repository for my health care records/concerns/behaviors. But agree with JGO that I would encourage plans to devote scarce financial resources to physicians…just not toss into their pockets but to reward practices for EHR adoption and to support physicians that are actively using patient centered HIT systems to truly improve quality and effectiveness of care.

]]> By: JGO http://ixcenterblog.org/archives/272#comment-104 JGO Thu, 17 Jan 2008 14:50:36 +0000 http://ixcenterblog.org/archives/272#comment-104 You have exposed the single, most sensitive nerve in the entire PHR discussion....where is and to whom goes the value of the PHR and who should pay for it. Having spent the past 8 years promoting the social benefits of EHR/PHR/EMR and even going so far as to promote the NHII (now NHIN or RHIO projects) I can tel you that the value proposition is spread across all healthcare constituents. But, and this is a hard pill for some to swallow, the PHR is "personal". What I mean is, that the personal aspect of the record is the core driver in determining value. I would argue that in today's short-sighted, give-it-to-me-now culture that the personal benefit will "win" and that the patient will end up registering and paying for their personal health record tools. I know, the big payers think they are doing everyone a favor by "giving" these tools to their members. But did you know that in many (if not all) cases less than 1% of a payer's member base has ever logged into the portal...and fewer than .05% have used it more than once? I wish the payers would stop paying for these tools which their members aren't using, and put their money into the pockets of the physicians where the care is actually delivered! You have exposed the single, most sensitive nerve in the entire PHR discussion….where is and to whom goes the value of the PHR and who should pay for it. Having spent the past 8 years promoting the social benefits of EHR/PHR/EMR and even going so far as to promote the NHII (now NHIN or RHIO projects) I can tel you that the value proposition is spread across all healthcare constituents. But, and this is a hard pill for some to swallow, the PHR is “personal”. What I mean is, that the personal aspect of the record is the core driver in determining value. I would argue that in today’s short-sighted, give-it-to-me-now culture that the personal benefit will “win” and that the patient will end up registering and paying for their personal health record tools. I know, the big payers think they are doing everyone a favor by “giving” these tools to their members. But did you know that in many (if not all) cases less than 1% of a payer’s member base has ever logged into the portal…and fewer than .05% have used it more than once? I wish the payers would stop paying for these tools which their members aren’t using, and put their money into the pockets of the physicians where the care is actually delivered!

]]> By: Record Access » Blog Archive » My Health Plan PHR Experience http://ixcenterblog.org/archives/272#comment-105 Record Access » Blog Archive » My Health Plan PHR Experience Mon, 07 Jan 2008 11:41:58 +0000 http://ixcenterblog.org/archives/272#comment-105 [...] (as opposed to integrated delivery systems like Kaiser Permanente, Group Health, etc.).” Article Josh Seidman, PCHIT, 3 January [...] […] (as opposed to integrated delivery systems like Kaiser Permanente, Group Health, etc.).” Article Josh Seidman, PCHIT, 3 January […]

]]> By: ICMCC Articles » Blog Archive » My Health Plan PHR Experience http://ixcenterblog.org/archives/272#comment-103 ICMCC Articles » Blog Archive » My Health Plan PHR Experience Thu, 03 Jan 2008 20:47:11 +0000 http://ixcenterblog.org/archives/272#comment-103 [...] (as opposed to integrated delivery systems like Kaiser Permanente, Group Health, etc.).” Article Josh Seidman, PCHIT, 3 January [...] […] (as opposed to integrated delivery systems like Kaiser Permanente, Group Health, etc.).” Article Josh Seidman, PCHIT, 3 January […]

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