Insurers Push Patients Toward E-Health Records

While the push continues to get more doctors to trade paper-based patient medical records for electronic ones, momentum also continues to provide consumers with digital access to their own medical data.

Health insurers, which have troves of patient medical data from the billions of claim transactions they process annually, are hoping that they can help speed adoption of consumer personal health records.

Blue Cross Blue Shield Association and America's Health Insurance Plans, which combined represent companies providing medical insurance coverage to 200 million Americans, said on Wednesday that they've created a "health-plan based" personal health record model and portability standards that will enable consumers to transfer their data when they change insurers.

The organizations also have set a goal for member companies to provide their consumers with new, standard-based personal health records by 2008. The organizations estimate that approximately 70 million Americans have access to personal health records through their insurers right now, with data that's populated by medical claims.

However, the level of data consumers have access to through their insurers isn't standardized, and varies from company to company. The new guidelines include defining the core data elements that all insurers should provide in personal health records for consumers, including patient medical histories, immunizations, allergies, medications, risks, plans of care, and other information that doctors have identified as being key data.

The insurers are aiming to also enable consumers to add their own subsequent information, such as family history of illness. Much of the information contained in the PHRs are "the sort of information you provide your doctor when you fill out those clipboard forms," says Alissa Fox, VP of legislative and regulatory policy at Blue Cross Blue Shield Association. But instead, a consumer could provide a doctor with a print out of the personal health record, or access the information online. The portability standards also would allow the consumer to transfer that data whenever they change health insurers. "Each insurer can have their own bells and whistles," to their personal health record offering for consumers, such as providing diabetic patients with electronic reminders about getting their medication refilled or eyes checked, says Fox. "Personal health records are great new tools to give consumers access to information that can help them better manage their health care," she says.

However, since the health-plan-based personal health records are based primarily on claims information, those systems "don't eliminate the need for health providers to deploy their own electronic medical records systems" for more detailed patient information, says Fox. But she says, "some providers are using claims data to populate" their records, because the claims data contain information about tests, medication, and other treatments that were ordered for the patient by other doctors.

Indeed, insurers providing their members with digital personal health records aren't a substitute for the use of interoperable e-medical record tools by doctors, says an AHIP spokeswoman. "We hope our work is a building block for when we have a fully interoperable national health information network," she says.