Personal Health Records Promoted, Pt. I

On August 10, 2008, The Hill posted an article entitled "Medicare expands online health records programs" by Jeffrey Young, who reported that "[t]he Bush administration is not waiting on Congress to pass legislation that increases access to online personal health records."

Beginning in January, the administration will expand access to online records in Arizona and Utah as part of an ongoing effort to encourage greater use of health information technology.

The records will contain up to two years of information from Medicare’s records. Patients will be able to add to their records and share them with physicians, pharmacists and other healthcare providers. * * *

Changing the operation of the Medicare system is crucial to its continued viability. In an article entitled "Making Medicare sustainable" delivered on February 5, 2008, as posted on The Hill as a budgetary message, Mike Leavitt, the Secretary of the U.S. Department of Health & Human Services, warned:

This week the president’s budget for 2009 was submitted. The Medicare portion of this budget should be viewed as a stark warning. Medicare, on its current course, is 11 years from going broke. * * *

The president’s budget on Medicare warns in a different way. It illuminates with specificity the hard decision policymakers — no matter their party — will face every year until we change the current system. * * *

But to keep our national commitment to seniors, we must do more to change how Medicare is managed. * * *

Implementation of an electronic medical records system was identified by Secretary Leavitt as one of the "cornerstones" of a competitive, efficient, reconfigured Medicare system.

Consistent with the movement by HHS to encourage use of electronic medical records, on October 30, 2007, WebMD Health News had reported, in "Doctors Urged to Get Electronic Records" by Todd Zwillich, that Medicare would offer incentives to persuade doctors to use electronic medical record systems.

Federal officials said Wednesday they would soon launch a program aimed at convincing reluctant doctors to buy electronic medical records systems for their offices.

Officials gave few details of the plan, saying it would not get going until late winter or early spring. But it will involve doctors getting cash bonuses from Medicare for buying electronic health records systems and then reporting quality improvements to the government. * * *

Many doctors are also reluctant to buy systems before industry and government groups have settled on a single standard for how the programs operate and communicate with each other. * * *

This incentive program was introduced in June, 2008. See: "Bush Plan Offers Bonuses to Medicare Doctors Who Use Electronic Records" (06/10/08) by Alex Wayne, posted on CQ Today.

One of the twelve regions included in the new program is Pittsburgh, Pennsylvania. I wonder, will this region have special input into the Commonwealth's investigation into electronic medical records, as recently implemented by Governor Rendell in an Executive Order? See: EE&F Law Blog posting "PA Governor Plans Electronic Health Info Exchange" (04/21/08).

Still, author Todd Zwillich again noted on WebMD Health News, in "A Slow Switch to Electronic Health Records", that "only 4% of U.S. doctors use fully functional electronic systems."

Less than one in 20 American doctors is using fully functional electronic health records and e-prescribing systems in their offices. And researchers say that figure shows that the switch to the new technology is moving too slowly.

Many experts say that computerized health records reduce medical errors and improve doctors' ability to communicate with patients and keep up with their care.

Government agencies for years have been pushing physicians and hospitals to adopt the systems but have met resistance, especially from small and medium-sized medical practices. * * *

In its newest, state-centered, pilot programs, HHS goes beyond such private incentive programs, to advance a vision of electronically created, stored, accessed, and linked personal medical records.

In "Medicare to launch personal health record pilot in Arizona and Utah" (08/11/08), posted on Healthcare IT News, Bernie Monegain reported that the most recent initiative announced for Arizona and Utah by the Centers for Medicare & Medicaid Services, of the HHS, "is aimed at providing patients with better care while also reducing costs."

It follows a similar initiative begun in April, 2008, in South Carolina, as announced in the article "CMS launches PHR pilot for Medicare beneficiaries" (05/07/08) by Richard Pizzi, posted by Healthcare IT News.

These CMS pilot projects encourage "traditional Medicare beneficiaries to use an online Personal Health Record [PHR] to track their healthcare services and better communicate with their providers."

The [first] CMS pilot -- which will take place in South Carolina -- gives Medicare beneficiaries the ability to collect and access information about their health or healthcare services, such as medical conditions, hospitalizations, doctor visits and medications.

CMS claims that strict privacy and security safeguards will protect all beneficiary data, and affirmed that the PHRs would be under the control of patients. * * *

In those pilot program states, beneficiaries can select one of the participating personal health record vendors, and then add additional personal health information to the claims data. For example, they may be able to authorize:

• Online links their personal electronic information, such as pharmacy data.
• Online tools that help consumers manage their health, such as wellness programs for tracking diet and exercise, medical devices, health education information and applications to detect potential medication interactions.
• Access by family members to their PHR data.
• Access by other healthcare providers to their PHR data.
  

Tomorrow, in Part II of this posting, I will review the efforts of technology giants with household names that have ventured separately into an expanded personal health record industry.