This week, the feds made two announcements that have pertinence to the PHR market.
CMS PHR Demo Launches in AZ & UT
First, CMS announced the launch of the trial PHR program for Medicare members in AZ and UT. Beneficiaries can chose a PHR that fits their specific needs and have it pre-populated with up to two years of claims data. Within these states, Medicare beneficiaries will have the opportunity to pick from four different PHRs to use:
- Google Health: The big boy in the group, but arguably the one with the least features in their core PHR product.
- HealthTrio: These were the ones that performed the CMS PHR trial in South Carolina.
- NoMoreClipboard: They had the best interoperabilty capabilities of any PHR vendor in our May 2008 iPHR Rpt.
- PassportMD: Based out of Florida, they offer a solution with high-touch service features.
Now that this is live, will be interesting to see just what the adoption rate is among the elderly. We’re not holding our breath. Note, previous posts for more background on the CMS demo can be found here and here.
My Family Health Portrait Gets Upgrade
And out of the Surgeon General’s office we have an announcement that they have updated the My Family Health Portrait (MFHP) service. While others are calling MFHP a PHR, it really doesn’t even come close.
MFHP does only one thing: It allows the consumer to enter various diseases contracted by various family members that a physician may later review to understand potential predispositions to diseases based on that family history. No, it will not store your list of meds. No, it will not have a list of your allergies, or advanced directives, or claims data, or clinical data or anything else that may often be found in most PHRs. MFHP provides only one service, a secure place to record one’s family disease history and then share it.
What many may not realize is that in fact, virtually all reputable PHRs in the market today already provide this capability to their customers, so it does seem a bit odd that the Surgeon General would go to all this trouble. However, there may be a silver lining here in that MFHP may provide a convenient stepping stone for consumers to become comfortable with entering health information online that can later be used with their physician. In this case a consumer is entering information with a trusted source, it is the Surgeon General after all, and the data being entered is not necessarily specific to them – more inferential and thus may not be viewed as sensitive. Having taken this initial step,and become comforatble with it, might the next step of the consumer be to use a more robust and complete service to record, store and access their complete health profile, ala a PHR or even one of the consumer Health Clouds from Google, Microsoft or Dossia?
First released as a downloadable app in Nov. 2004, the Surgeon General’s office quickly migrated MFHP to a Web-based service in Nov. 2005, and there it sat for three plus years with little visibility (I never heard of it) and attracted roughly 25K who created a family health portrait.
On Jan. 12, 2009, following guidance from AHIC, a new version of MFHP was released. According to the website, the new version is:
- Standards-based: Leveraging work done by the American Health Information Community (AHIC), both technical and core data standards have been built into the FHH 2.0 design. This means an increase in interoperability and a diminished learning curve for consumers, practitioners and researchers. They are using HL7 Family History Model, LOINC, SNOMED-CT and HL7 Vocabulary. Wonder why not CCR?
- Shareable: Information can be electronically shared by the consumer with family members and healthcare providers. This new feature allows consumers to collaborate with family electronically to develop a more robust family health history record. Somewhat surprised that this was not a feature of the original Web-based version.
- EHR-Ready: Version 2.0 produces xml files that can be easily integrated into existing EHRs with little customization or IT support needed. Its as simple as copying an electronic file from one location into a new system. Obviously, since they are already using HL7. Big question is, will a doctor actually import this into their EMR. Also, do the Health Clouds today already have the data architecture/data elements in place to accept this data, let alone the plethora of PHR vendors?
- Customizable: The tool can be downloaded for adoption under an organization’s own brand. It is intended to be easily adaptable into patient care portals, thus allowing healthcare organizations to promote family health history taking under their own brand, use it within their own secure environment, and contribute to comprehensive “one-stop-shopping” online patient service portal. We like this feature as it will enable providers to readily adopt MFHP, for very little $$$, rather than re-invent the wheel.
Since the announcement went out on Jan. 13th, those responsible have reported to us that they are already running into server capacity issues. Looks like there is a demand, or at least interest in this type of service. Checking back in 6 months will prove whether or not there is sustaining interest or this is just a flash in the pan.
John – the MFHP has its roots in the genome related research side at the NIH (www.genome.gov) – orginally published by the National Human Genome Research Institute @ NIH.
The real utility here is to sync data from various apps such as MFHP using HL7 v3 Clinical Genomics Family History Standard – connect to genetic labs for testing hereditary forms of cancer – breast and ovarian cancer are good examples. Hereditary conditions tend to be defined by number of relaivtes with a condition(s), degrees of separaton from the relative etc. Also useful in genetic counseling.
THe HL7 EHR Functional Model also has a family history function.
Exchanging family history – surfacing clinically relevant SNP data – and then linking them to EHRs could potentially enhance risk assessment.
Steve Murphy MD over at The Gene Sherpa / Helix Health has a little post on the MFHP – http://thegenesherpa.blogspot.com/2009/01/surgeon-generals-family-history-redux.html
And if HealthVault for example can pull in dbSNP data types – I would think Sean Nolan & Team should be able to pull this in with relative ease.