Interoperable PHRs Offer Best Value for Insurers

Of the four models of personal health records (PHRs) that payers, providers, and health systems might be tempted to purchase, interoperable PHRs (i.e., those that are populated with data from all regional data sources via standards-based automated data exchange), may be the type that provides the best value for health plans and insurers.

That’s the finding of a report from the Center for Information Technology Leadership (CITL), a research organization based at Partners Healthcare System in Boston.

The organization estimates that PHRs could save the United States health system $21 billion a year. PHRs are defined as Web-based systems that allow patients to maintain their medical data and use that data to better manage their health care.

“The interoperable model enables the exchange of standardized health information across platforms. This model allows different systems to talk to one another. Right now, systems can only talk to each other with the help of very skilled people who create the interfaces and standardize the data so that it can be exchanged and shared,” says Doug Johnston, executive director of CITL and one of the authors of the report.

The other three models reviewed were the provider-tethered, payer-tethered, and third party models.

  • Provider-tethered PHRs are connected internally to the database of the provider’s electronic health records. Patients can communicate with other providers and payers via manual communication channels but are unable to directly integrate external data.
  • Payer-tethered PHRs connect members to health insurers’ administrative databases. Patients can communicate with providers and other payers via manual communication channels such as secure e-mail, but are unable to directly integrate external data.
  • Third-party PHRs aggregate data through manual data exchanges, which import data from external sources but are unable to feed the data into clinical or administrative systems.

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HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

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