CMS Gives PHRs a Vote of Confidence

Kathryn Mackenzie, for HealthLeaders Media, December 2, 2008

Personal health records are gaining wider acceptance among even those who are typically slow to adopt new technologies. Case in point: last month acting Centers for Medicare & Medicaid Services administrator Kerry Weems and HHS Secretary Michael Leavitt announced they have chosen four PHR companies to participate in a pilot program in which Medicare patients can choose one of the selected PHR companies to maintain their health record information electronically.

Under the Medicare PHR Choice Pilot program, which begins in early 2009, seniors in Arizona and Utah can access their personal health data from CMS databases using Google Health, HealthTrio,, and PassportMD.

The move by CMS to pilot PHR technology is significant because the agency is widely recognized as being very conservative when it comes to adopting new technologies, as John Halamka, MD, CIO of Harvard Medical School and Beth Israel Deaconess Medical Center points out in his blog.

"The fact that CMS has linked the Medicare database to Google Health and other PHRs implies that CMS has embraced Healthcare 2.0 approaches to infrastructure and has validated the importance of personal health records," he writes.

Under the pilot, Medicare beneficiaries will be able to collect and store personal health information from other authorized sources in their chosen commercial PHR. Depending on the type of PHR selected, members will be able to directly link their pharmacy data with the PHR and also add other personal health information. Members can also connect to tools for tracking diet and exercise, find information about drugs and medical devices, health education information, and applications to detect potential medication reactions. Beneficiaries can authorize care providers and family members to have access to their PHRs. CMS says it will transfer up to two years of the beneficiary's claims data into the individual's PHR, on beneficiary requests.

Medicare's pilot program may also mean more than just the wider adoption of PHRs among the public. Since CMS is the biggest payer of healthcare in the US it can also act as a driver of change through reimbursement policy, writes Halamka. "By offering patients access to their own claims data, CMS will create patient expectations that will motivate the private payer community to do the same."

It will be interesting to see how successful the program is. Are there enough tech-savvy seniors out there to support a program like this? Weems and Leavitt certainly think so. "This pilot is on a fast track. Time is short. Especially given the 'silver tsunami' of baby boomers that are on the cusp of retirement," Weems said during a press conference to announce the Medicare PHR Choice Pilot. Weems says CMS has been working for several years "to build a framework for an interconnected electronic information system that works quickly and seamlessly. PHRs are another piece in this puzzle."

Though CMS has used its significant voice to offer up a vote of confidence for PHRs, it remains to be seen whether the roughly one million fee-for-service Medicare beneficiaries within the pilot project boundaries will choose to participate. Since CMS has left it up to the vendors to educate the residents of Arizona and Utah about how PHRs operate, it will be interesting to see just how much they are able to accomplish before the program launches early next year.

Kathryn Mackenzie is technology editor of HealthLeaders magazine. She can be reached at
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