Health plans are at the front lines promoting healthcare consumerism, giving members the tools and resources they need to control and manage their healthcare, especially online, where progress and engagement meet. Their efforts to support a more empowered patient dovetail with their work to advance the use of technology in medical record keeping. It does more than engage their members—it helps providers make better decisions and, ultimately, make an impact on the delivery, quality, and outcomes of their care. Yet the modern digitization of healthcare (see EHRs and Digital Healthcare in Today’s ACA Environment) is a long and winding road, making health plans an essential part of its development.
Seeking a Complete Picture of a Patient’s Health
Electronic health records (EHRs) are the legally mandated data needed for insurance claims and patient care that are maintained in digital format by the physicians or institutions (e.g. hospitals, pharmacies, labs, and health plans) who own them. And while many health plans provide individuals with a view into their information through a patient portal—and even include helpful tools such as electronic messaging, appointment scheduling, and health trackers—the EHR doesn’t necessarily reveal a complete picture of the patient’s medical history or status. This complete picture is arguably what’s needed to maximize the value of digital records for patients, providers, payors, and other healthcare players.
At this point in time, most people’s medical records are spread out among providers and exist in disparate formats (including paper), and they’re shared between providers upon request over fax or some other form of electronic transfer. They’re rarely accessible in one convenient location. For as much data is digitized, the healthcare system has not yet defined standards or established policies for data collection, storage and exchange, making it difficult to meaningfully combine EHRs from different sources—there is a need for interoperability between platforms and systems. The Office of the National Coordinator for Health Information Technology (ONC) is leading efforts to further health information technology and promote a nationwide health information exchange (HIE), and stakeholders across the healthcare system are eagerly working toward an efficient and cost-effective solution.
Pulling It All Together
In the meantime, one solution puts the consumer at the center of the recordkeeping process: the digital personal health record (PHR)—information owned, maintained, and controlled by the patient; essentially, it’s a complete, comprehensive, consumer-driven extension of the patient’s EHR. It might include:
– Medications – prescription and dosing
– Allergies, illnesses, and chronic conditions
– Lab results and imaging reports
– Dates and details about surgeries
– Vaccination dates
– Living will
– Health insurance policy details
And, importantly, a PHR can incorporate information healthcare providers or payors might not have in their records, like a person’s dietary and exercise habits, sleep schedule, use of over-the-counter drugs, and family history. Having this information in one place makes treatment easier for patients and providers in the case of an emergency, while traveling, or at a first visit.
Enhancing the EHR with a PHR
Health plans already have access to much of their members’ health data, particularly that relating to claims, making their patient portals an excellent place for people to start their PHR. According to the Center for Information Technology Leadership at Partners Healthcare System in Boston, widespread use of PHRs could save the US healthcare industry between $13 and $21 billion per year, thanks to a more engaged patient and improved care coordination. That’s one of the reasons why health plans are helping their members to access their EHRs within an online patient portal, and why they should encourage members to establish a supplementary PHR. This might mean adding functionality to their EHR “toolbox,” such as the ability for members to enter or upload additional medical records, or sync the portal with a proprietary or commercial PHR solution.
Points to consider as a health plan develops the technology to help members organize their health information:
– Make PHRs useful for clinicians and other members of the patients’ care team, such as health coaches.
– Ensure members see the value of PHRs and find them easy-to-use. This requires education and active promotion of the tools and best practices.
– Incorporate PHRs into mHealth initiatives like telehealth applications and mobile apps.
EHRs and PHRs are part of a rapidly growing area of health IT—and health plans are in an ideal place to provide innovative solutions. Keep up to date and learn more about PHIs and EHRs here: