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'Til death do us part

OptumHealth creates lifetime PHR

OptumHealth’s recent announcement about lifetime personal health records (PHR) suggests Americans may soon add another certainty to the Benjamin Franklin adage about death and taxes.

While the healthcare industry watches Google and Microsoft’s entry into the PHR arena, OptumHealth has created a lifetime PHR program that allows consumers to maintain and update their online health record regardless of employment, health plan, or doctor changes.

More than 21 million consumers from sister company UnitedHealthcare and OptumHealth’s private employers or payers can access their PHRs through the company’s free, secure consumer Internet portal, HealthAtoZ.com.

Those who later leave OptumHealth’s care will still have free access to their PHR via the Web site, their health insurers will no longer populate the electronic record with claims data, but individuals can continue to self-enter information into their PHRs.

In addition, anyone with Internet access can selfenter and create his or her own PHR at www.healthatoz.com for free.

Harlan Levine, MD, chief medical officer at OptumHealth Care Solutions in Golden Valley, MN, says the lifetime PHR is an example of the company’s “consumer empowerment” focus. Levine says PHRs play a critical role in healthcare, especially as care and society become more fragmented.

“The personal health record can be the central location to consolidate all that information to help [consumers] move through the healthcare delivery system,” Levine says, “and help ensure they are not prone to medication errors or gaps in care because of the disruption of data flow.”

Levine says a barrier to greater PHR use is that consumers view them as temporary tools because PHRs usually aren’t transferable if the consumer changes health plans, jobs, or physicians. He says OptumHealth’s lifetime PHR eliminates that issue.

“There is tremendous value in managing healthcare through a personal health record, but what has been challenging in the industry is adoption,” says Levine. “[The lifetime PHR] is part of a broader strategy to make this more appealing and to overcome the barrier that this is a short-term solution as opposed to information that a consumer can access anytime—essentially a lifetime benefit.”

The electronic PHR through OptumHealth can be populated with claims data, such as hospital and doctor visits, immunizations, lab results, and prescriptions, as well as information from health risk assessments. PHR users can also self-enter information, including family history, previous medical history, or a living will, and can track their sugar levels, weight, diet, and other health-related data.

Levine believes that having prepopulated information will spark potential users to take part. “I think the fact that you’re not starting from scratch and information is being input into the personal health record makes it much more likely that the consumer will go to the personal health record, because the hardest part is getting started,” he says.

Joseph C. Kvedar, MD, founder and director of the Center for Connected Health in Boston, would like to see proactive and engaged PHR users. The center is a division of Partners Healthcare that is applying communications technology and online resources to improve access to and delivery of quality patient care. With current warnings about physician shortages and baby boomers approaching their senior years, Kvedar says having an active, educated patient involved in his or her care is vital.

Healthcare companies shouldn’t merely populate PHRs with claims information, says Kvedar. They should encourage consumers to take ownership. “The approach I like better is to motivate patients to input their own data, because by enabling patients to collect and better understand their own health data, we can push or pull them into the self-care mode. To succeed, we need patients to be much more aware and involved in the self-management of their health,” says Kvedar.

Kvedar expects the movement toward greater PHR integration will come because of economics, not patients. Payment reform, in which healthcare providers are held accountable for quality of care rather than number of transactions, will make tools such as PHRs more important. “The pain point, no matter how you look at it, is the cost of care,” he says.

Users have the ability to grant PHR access to doctors, nurses, loved ones, or anyone involved in their healthcare.

Of course, any time computer databases are involved, one of the first concerns is privacy. The World Privacy Forum released a consumer advisory February 20 about “the potential privacy risks in personal health records every consumer needs to know about.”

The report warned consumers that some PHRs can compromise consumer privacy. Levine says OptumHealth addresses those concerns through password protection and encryption technology to help protect patients’ information.

In addition to the PHR, OptumHealth’s Web site includes a symptom checker, health assessment, personalized dashboard, nurse chat, online health coaching, calculators, and health-related articles. The symptom checker was created with the assistance of the company’s nurses, who provide clinical guidance to callers on a daily basis.

“We believe that consumers need a trusted source for health content, and for that reason, the health content we deliver has been vetted through an in-depth review process,” says Levine.

The health information is also specifically geared toward the individual, based either on self-selected areas of interest or health risk assessment results. Using that information, the Web site presents topic-specific articles or information about health programs. “The goal is to make it relevant to the individual,” explains Levine.

Levine says the lifetime PHR is important to OptumHealth from a strategic point of view. “This is an opportunity to create tremendous value. As people adopt and use personal health records more, we will have broader capabilities to alert them to, and make available to them, programs that can support their healthcare needs,” he says.

Ann Fleischauer, director of communications at OptumHealth, believes people will take charge of their healthcare through their PHR. She foresees patients bringing a printed copy of their PHR with them to the doctor. This not only will help the patient, but the doctor as well.

Levine believes that within three to five years, the information in PHRs will become much more relevant to busy physicians taking care of more patients. “Phy-sician adoption will then catalyze broader consumer utilization,” he says.

Since OptumHealth created its first PHR in 2005, the company has been updating and improving the document. With the lifetime PHR now in place, company officials expect that progression will continue.

“As the industry continues to move forward, and consumers have growing needs and become more engaged and empowered in their own healthcare, our site will continue to evolve, and we will continue to make value-based enhancements,” says Levine.