Massachusetts Promotes Consumer-Driven Health Care on the Web

Comparison shopping, it's not just for the grocery store anymore! In Massachusetts a new website is being unveiled today (with a barrage of advertising) that provides consumer resources for making informed health care decisions.

The Boston Business Journal takes a look at this new online resource and the non-profit organization that launched it:

The non-profit Partnership for Healthcare Excellence on Thursday began an advertising campaign and is now actively promoting its Web site -- www.partnershipforhealthcare.org -- which links consumers to various sources for care and cost data.

"We want to build an 'on ramp' for consumer engagement in health care,'" Jim Conway, Partnership chairman, said in a statement. He's also the senior vice president of the Institute for Healthcare Improvement, a local think tank and Partnership member.

The Partnership initiative is one of many efforts to promote the "consumer-driven" health care movement, which would give consumers a greater voice in their health care choices in an effort to manage costs more efficiently. Such efforts have increased in recent years because health care costs have continued to rise at double-digit levels.

WBUR 90.9 FM, a Boston based public radio station, had Mr. Conway write a guest column for their website this morning. Here is a small sampling from it:

This is a new non-profit that includes more than 40 organizations - including the Massachusetts Health Care Quality and Cost Council, consumer associations, disease and advocacy organizations, doctors, nurses, hospitals, insurers, business groups, and labor....

By arming consumers with useful information such as how to take medications safely, choose a doctor or hospital, and prepare for doctor and hospital visits -- the Partnership gives them tools to improve the quality of their care. It will also be encouraging consumers to advocate for overall system change -- like supporting the wider use of e-prescribing and the rapid introduction of tools to help consumers manage their medications.

We all know the sad litany of statistics about medical errors. We also know that one of the strongest weapons we have in the fight for quality is the informed, empowered and engaged patient. Today, patients have a new ally in the fight for quality -- The Partnership for Healthcare Excellence.

It will be very interesting watching this develop over time. Informing prospective patients of the variations in health care quality they will face, before having to face them, could well be a good tool for helping market forces drive down health care costs. Only time will tell.

SOURCE: "Mass. Web Site to Promote Consumer-Driven Health Care" 10/25/07
SOURCE: "A New Ally for Patients -- The Partnership for Healthcare Excellence" 10/25/07
photo courtesy of George Williams, created for the "Health Care Reform Now!" Blog

HealthVault: Holy Grail or Pandora's Box?

How many aspects of your life do you handle online? Do you buy books from Amazon? Do you bid or sell on eBay? Do you check your bank balance in a browser? How about your investments? Do you communicate by email more often than you write physical letters? Most modern Americans do at least one or two of these things on a regular basis. Now consider this, when was the last times you looked at your prescriptions, X-Rays, or health records online?

The advantages and cost savings of EMRs are consistently touted, both on this blog and in many other places. The recent unveiling of Microsoft's HealthVault makes it seem a viable EMR option is looming on the horizon. While at first glance this is a good thing there are many who seem uneasy about it. Robert Langreth, Senior Editor for Forbes, is one of them:

Microsoft, the company whose personal computer software is regularly attacked by hackers, the company reprimanded by governments for its aggressive monopolistic behavior?

While the aknowledged leader in the field of computing, Microsoft's history does lend itself to some unsease when considering privacy concerns (Win XP, Service Pack 2 anyone?). Langreth's interview with Peter Neupert, Microsoft VP in charge of development for their health group, is an interesting one as Langreth tries to counter that perception.

Microsoft argues that HealthVault can avoid the countless security problems that have afflicted its operating systems. "It's an apples and oranges comparison," he [Langreth] asserts. "It's a lot easier for us to manage a service for reliability, security and privacy than it is to manage hundreds of millions of distributed personal computers." Microsoft is working with two hacker organizations to test the security of its system.

Although HealthVault will be free for consumers, this is no philanthropic effort. Microsoft hopes HealthVault will translate into more search revenues through targeted health-related ads. The site includes an improved online search that uses a machine-learning algorithm to help consumers search through articles on health issues by breaking broad topics into concrete subcategories.

"By providing a great health search experience, we will actually improve the search loyalty of Microsoft overall," says Sean Nolan, the Microsoft programmer who designed the site. He admits though that moving into the medical record arena "is a huge crazy challenge." Among other issues, Microsoft will have to tiptoe the line between assuring people their information is private -- and serving up advertisements relevant to the health problems they have.

Walking that line might be easier than suspected. The success of numerous social networking sites, as well as online products such as the Google suite of applications show that while this is a concern it seems a rapidly diminishing one. People everywhere are getting used to seeing keyed text ads in the margins of their Gmail / Hotmail / Yahoo mail, getting reccommendations from eBay and Amazon when shopping, and generally having their data not only stored on the net but also implemented for promotional means.

Is this good? Is this bad? Will the public embrace or revile it? Only time will tell.

It is, after all, "a huge crazy challenge."

SOURCE: "Who Are You Going To Trust?" 10/08/07
Photo courtesy of: Library of Congress via pingnews.

Microsoft Trumps Google with Online Health Service

Microsoft has beaten Google to the punch on offering an online health records solution.

Both companies have been developing online systems for Electronic Medical Records (EMRs) for quite some time now. A prototype of Google Health was shown to health professionals and advisors in August of this year, but has yet to launch and may be experiencing difficulties after having recently lost its leader Adam Bosworth.

While Google Health remains in limbo, Microsoft's HealthVault, announced in Washington yesterday, is now online and includes an impressive array of partners, as pointed out by the New York Times:

The organizations that have signed up for HealthVault projects with Microsoft include the American Heart Association, Johnson & Johnson LifeScan, New York-Presbyterian Hospital, the Mayo Clinic and MedStar Health, a network of seven hospitals in the Baltimore-Washington region. The partner strategy is a page from Microsoft's old playbook. Convincing other companies to build upon its technology, and then helping them do it, was a major reason Windows became the dominant personal computer operating system.

The service is free to consumers and revenue will be generated by search driven advertising, something ubiquitous in Google's online applications such as Gmail.

Information Week compares this to other efforts :

Microsoft's consumer-centric model for PHRs differs from the approach others are taking, especially employer-sponsored PHRs, like Dossia, a consortium of employers including Intel and Wal-Mart, which is building a PHR system for its workers.

Although Dossia says its employer members will not have access to workers health data, in the larger picture, trust and privacy questions are issues that hinder consumer confidence in electronic medical records systems overall, including PHRs offered by health plans and insurers.

However, with the consumer being the controller of data in HealthVault, users may be more accepting, said Deborah Peel, founder of privacy advocacy group, the Patient Privacy Right Foundation, who was a speaker at the HealthVault event.

CRN reminds us of prior Microsoft attempts using this consumer driven model:

Whether consumers will trust Microsoft to manage sensitive health information is an open question. Microsoft takes pains in HealthVault's terms of service to specify that it will not use any information stored at the site for commercial purposes or release it to any outside parties without explicit permission. However, customer concerns about giving Microsoft access to a treasure trove of personal data killed off Microsoft's Hailstorm project five years ago, which aimed to aggregate users' financial and other personal details in one Microsoft-owned repository.

SOURCE: "Microsoft Rolls Out Personal Health Records" 10/04/07
SOURCE: "Microsoft Unveils Free Web Health Tools for Consumers" 10/04/07
SOURCE: "Microsoft Beats Google To Consumer Health Market" 10/04/07
photo courtesy of Orangeacid using this Creative Commons license

Convenient Care Clinics

Web Golinkin, President and CEO of RediClinic, wrote an article in today's Wall Street Journal extolling the virtues of convenient care providers. Golinkin has familiarity with the subject, as RediClinic is one of the largest convenient care providers in the U.S.

Golinkin calls these clinics "[o]ne of the most promising developments" in health care reform. He says that they provide patients easier access to routine care with affordable pricing.

There are currently about 400 such clinics nationwide and Golinkin predicts that there could be several thousand more in the next few years.

Although the medical community was suspicious of convenient care in the beginning, many physicians and professional organizations changed their view when they saw how rapidly consumers embraced the concept and how operators provide high-quality care within a limited scope of practice, treat many patients who do not have established physician relationships (an estimated 30% of all convenient care patients to date), and refer many others. The American Academy of Family Physicians, which represents more than 94,000 family practitioners, recognized that convenient care clinics were filling a need. Rather than opposing the clinics, it published standards of care that it suggested convenient care operators should follow. Operators gladly complied because they had been meeting or exceeding these standards. The Convenient Care Association, which represents more than 20 of the largest operators, subsequently published more stringent standards that their members are now required to meet.

Golinkin is also director and co-founder of the Convenient Care Association.

SOURCE: "Health Care When You Want It" 08/02/07
stock photo courtesy of Michael Connors

Medical Records on the Internet

The Wall Street Journal ran an editorial by digital diva Esther Dyson
having to do with health care reform. (Journal articles require
registration to view.)

Dyson begins with this announcement:

In a couple of months, my genome, my answers to a substantial health questionnaire and my medical records (as many of them as I can collect, anyway) will be posted on the Internet for all to see.

Ms. Dyson -- who has a stake in several health-related start-up companies -- is one of 10 pioneers who have agreed to participate in the Personal Genome Project run by Harvard University geneticist, George Church.

Dyson explains that there are privacy concerns about putting this much personal health information online, but she believes the benefits will be worth it.

In his book, Health Care Reform Now!, author George Halvorson makes similar claims to Dyson's about the potential benefits of having health records accessible on the Internet:

We are on the very edge of using the Internet to improve care in a great many ways, both with individual patients and with caregivers.... Caregiver[s] would not need to wait years to attend a seminar to learn [a] new technique.

How do you feel about having your medical information available on the Internet? Do you think it's a bad idea that will lead to abuse of data, or a good idea that will lead to better care?

We'd love to hear your opinion. Comments are open but moderated.

SOURCE: "Full Disclosure" 07/25/07
photo courtesy of FreeImages