Personal Health Records going from step child to favorite son

Having lived in this space for several years, I can tell you that the PHR world has gone from sleepy "cottage" , "mom and pop" industry to the hottest sector in healthcare IT.

Why?
Several reasons...EMR's were the "favorite son" of every investment firm, government legislator and healthcare IT..the great promise of EMR's were highly tauted as the savior of the medical industry...for the last 20 years...everyone was betting on the EMR's to transition US healthcare from caveman record keeping to real world real time interoperable pie in the sky exchange...but the fireworks turned to a small fizzle...when the realism of pushing entrenched doctors, already squeezed by health insurers and liability issues and government regulations, to purchase expensive technology systems for their practice died. Why would a doctor spend another 25,000 a year per provider to interrupt his practice when he has watched his income go down, his hours go up, and regulatory burdens suck the pleasure out of practicing medicine? Well, the answer is..they wouldnt...would you?

So, after 20 years of promise..the industry went through major consolidation with very few little guys left...and at the end of the day...only 20% of docs in the best case scenario have picked up the cost of EMR's...

So, the wise men on the hill realized that the goal of healthcare IT transformation will not be through waiting for docs to adopt EMRs...The answer is PHRs or Personal Health Record Systems...neglected for years until lightening strikes last year...and standards for Personal health record systems int he form of CCR/CCD are adopted. That was the critical happenstance. As soon as the standards were adopted by the AMA, AAFP, the CCHIT mandated that all backend EMR systems accept the standard for certification and everyone soon realized that the way to drive the electronic healthcare revolution is through this piece...give it to the consumer...make it interoperable..if the consumer takes his record with him wherever he goes..or said differently if his record goes with him...then the record will be the piece that drives the adoption of the EMR. And I think the Medicare Pilot program is a testament to this, the government is ready to push this...So, the PHR goes through all the different disparate systems and the patient (rather than the physician) drives the adoption...I believe that is what is going to happen. The patient will be incentivized to adopt the phr via health insurance cost incentives..less costly premiums or covering the expense of the cost of PHR for the individual insured. (Recent study from Partners Healthcare in Boston shows health insurers save over $20 billion per year after giving phrs' to people). The last incentive will come from government and health insurers that push doctors to update the phr and read the phr through the CCD/CCR standard.

So, when we read in the NY Times, “Health information technology will succeed only if privacy is protected,” said Frank C. Torres, director of consumer affairs at Microsoft. “For the president-elect to achieve his vision, he has to protect privacy.”

Mr. Torres is correct except the privacy part is a given...just as bread is necessary for a sandwich...but what lies between the 2 pieces of bread is what really distinguishes the sandwich..and in my opinion the absolute , without question, necessity for health information technology to succeed and for Obama to reach his goals...the only answer and the only critical part is the incentive that must be provided to the doctor to participate and the patient to participate...without the incentive , it fails..I believe Obama knows this or they should read this..so they understand that they must properly incentivize the active participants or we will wait another 20 years ...


The good news is...the incentives are coming...(and I see EMR systems merging with PHR's as all ASP systems that dont cost anything for the doctor to use-will discuss in future blogs)