Personalized health information becomes a reality, empowering patients to improve the quality of their healthcare.
In 2004, President George Bush called for every US resident to have an e-health record by 2014. That goal, admirable though it may be, is quite basic compared to what health informatics can actually achieve. Ideally, the concept can be expanded to not only give patients access to their e-health records but also to information relevant to their unique health issues and concerns.
Through this extension of personalized medicine, e-health databases will become not just repositories of patients’ medical history, but resources that help patients manage their health and healthcare consumption. When patients become stewards of their own health records and are supplied with cost and quality metrics that inform their healthcare decision making, reminders about preventative measures and information that supports ongoing treatment adherence, they are able to take a proactive role in improving the quality of their health.
Although society is barely out of the starting gate in realizing this ideal, patients could have electronic access to personalized health information almost overnight through the collaboration of health plans and other health information providers who are at the ready. It is no longer a theoretical possibility, but a technical capability.
The argument for personalized health information
The basic premise of personalized medicine is to improve the quality of care by delivering the right treatment to a patient at the right point in time. And the rationale behind giving consumers access to personalized health information is that with the right information resources, they can be proactive in seeking and selecting the right treatment at the right time. With access to their complete health history; treatment guidelines for diagnosed conditions; and information on the cost and quality of providers, treatment alternatives, products and services, patients can become savvy and proactive consumers of healthcare services.
Until recently, the healthcare system has treated patients as bystanders in their own medical care; however with the wide availability of health information on the Internet and patient-directed education programs by pharmaceutical companies, patients have embraced a new level of involvement in decisions about their healthcare. Their ability to be truly effective has, however, been hampered by several factors:
- Patient records are kept in multiple locations and systems. Even those that are electronic are not integrated across providers.
- The latest medical research and treatment guidelines, while often available on the Internet, are not always translated into terms that most patients can understand.
- Few resources exist that allow patients to compare costs using personalized calculations and to evaluate the quality of providers.
The right forces are finally converging, however, such that patients can become the nexus of their own healthcare information. Health informatics—or the acquisition, storage and use of information to deliver healthcare and promote health—will quickly become one of the fastest growing segments of healthcare.
There are three possible routes to achieving the widespread availability of personalized health information.
The Provider-Centric System
It is possible for physicians and other providers to create and populate electronic medical records for patients—and an isolated few medical centers already do this as a patient service. This is not likely to be the means by which all Americans have access to comprehensive files on all their encounters with the healthcare system, though, since relatively few providers maintain medical records in a way that would be useful to patients. According to the 2006 National Ambulatory Medical Care Survey conducted by the U.S. Centers for Disease Control, only 29 percent of the country’s physicians rely on any form of electronic medical record systems, and only 9 percent use them to their fullest. And, physicians are not accustomed to making file notes to be read by non-medical personnel. What is more, there are scores of electronic record systems on the market, and they are not yet interoperable. The Healthcare Information Technology Standards Panel, a public/private partnership, is dedicated to harmonizing standards so that healthcare information can be shared between organizations and systems, but the task is immense.
Under this model, patients maintain their own health information account in an encrypted database that has been created for them by a health-record service provider. Patients can input information themselves and direct providers to upload records into the database. Several technology companies with household names have recently launched such offerings within the past year, or have them in development. Two notable players in this arena have each collaborated with a different renowned hospital.
It remains to be seen how widely these services are adopted, particularly since they put the onus on patients to populate the database—something that only the most motivated patients are likely to pursue and maintain over time. As noted previously, relatively few providers thus far have electronic records that could be transmitted to the patient’s private health portfolio, and the existing systems are not uniform, inhibiting attempts to integrate information from multiple sources.
Health Plan- or Employer-Initiated Systems
The third model—and perhaps the most practical and the one that will gain the most momentum—are personal health databases populated by integrated medical claims data retained by health insurers. Information from medical claims databases include details on physician visits and other outpatient services, diagnoses, laboratory test values, prescriptions filled and inpatient services. The technology platform and formatting is created either by health plans directly as a value-added service to their members, or by employers and information is “pushed” to users. Still, standards must be set so that individuals who switch employers and health plans can roll their records over into a new system.
Some progressive employers such as Wal-Mart, Intel, IBM and Dell have already worked in conjunction with their health plan providers to create personal health record systems as a benefit to their employees.
By teaming up with established health information providers, health plans can go one step further: they can supplement their claims data with other information useful to patients such as performance profiles on providers, cost of care measures for various conditions and procedures, and even treatment guidelines in layman’s terms. Offering such full-service information packages is a way for health plans to differentiate themselves with employers and, at the same time, reap the benefits of a more informed, more empowered individual membership.
The good news is that all of this supplemental information is readily available, along with the delivery mechanisms and user-friendly viewing tools. Health plans that choose to, can offer the benefit of personalized health information to members today with little to no development time.
For health plans, the issue is no longer one of IT capabilities or of whether the market is ready for such a service. Rather, the issue is simply whether health plan providers want to move beyond being insurance companies to becoming health informatics companies.
About the Authors
Antonio is the founder of Health Benchmarks Incorporated, a unit of IMS Health. His expertise includes the evaluation of quality and cost-effectiveness of healthcare, with a focus on outcomes research, quality of care metrics, and cost-effectiveness analysis.
Michael DeSimone has 18 years of extensive healthcare experience, specifically working with healthcare and data analytic clients on variety of personalized healthcare benchmarking initiatives (e.g., biologics).
Filed Under: Drug Discovery