The provider market has always been a key market for PHR vendors, but most PHR adoption and deployment efforts are led by a provider’s marketing department to improve customer service and increase retention. That is beginning to change.
In Chilmark’s periodic calls with numerous PHR vendors we are beginning to see an uptick of interest among providers in PHRs that goes beyond serving the marketing department’s objectives. Providers are now looking to PHRs to assist them in their efforts to improve care transitions (inpatient -> outpatient), reduce hospital re-admissions, and leverage telehealth for chronic care management. In each of these cases there is money to be made (pay for performance and disease management programs) or saved (CMS & payer rules not reimbursing hospital re-admits within specific time period).
When Chilmark published it’s iPHR Market Trends report last year we identified the provider market as one of the key markets for PHR solutions (25% of those interviewed stated provider market was primary), with the other two key markets being payers (15%) and employers (35%). At that time, however, it appeared that the provider market was not particularly attractive to most independent PHR vendors as providers typically gravitated to their EMR vendor for a tethered PHR such as Cleveland Clinic’s and Kaiser-Permanente’s use of Epic’s My Chart. For those providers with more complex, multiple legacy EMR environments, the PHR solution they typically deployed was a basic patient portal such as MEDSEEK.
But as providers’ needs for their PHR platform have become more complex, the lack of investment by EMR vendors in their PHR solutions is beginning to show. This lack of investment is unlikely to change as EMR vendors now focus their efforts on chasing ARRA (Stimulus) funding.
The situation for patient portals is not much better. As a first generation outreach mechanism for marketing departments, a PHR based on portal technology was fine. But what leading providers are beginning to discover is that most patient portal solutions are pretty generic, simplistic apps that are not capable of delivering the more advanced functionality they are now seeking.
What are leading edge providers looking in these independent PHR solutions?
Ability to aggregate and present relevant, personalized information to the consumer. This goes beyond basic generic content and simple reminders that are currently found in most PHR solutions. The Mayo Clinic’s recent launch of the HealthVault app, Health Manager, is a move in that direction.
Deeper, richer customer experience (content, biometrics, feedback/interaction) that is pertinent to their specific chronic disease for improving disease management and reducing avoidable hospitalizations. PHR vendor NoMoreClipboard is currently working with Howard University on using their platform for diabetes management in the District of Columbia. Cleveland Clinic has an interesting ongoing biometric trial using HealthVault’s Connection Center.
A clinician interface to the PHR to facilitate their interaction and use of the app with the consumer. This might include consumer generated biometric data seamlessly feeding into the clinician’s workflow. May also include embedded clinician decision support as well.
Capabilities to more effectively manage care transitions from inpatient to outpatient settings and thereby reduce re-admissions within the critical 30 day window after discharge. The recent launch of MyNYP.org is an example of such for cardiac patients at New York Presbyterian.
The provider market is the largest PHR market today and it is likely to stay that way for years to come. PHR vendors looking to serve this market, however, need to rethink their strategies and begin delivering solutions with deeper functionality than what most have on display today. The days of simple tethered PHRs that are nothing more than a patient portal view of an EMR will fade over the next few years as providers seek to capitalize on new opportunities for consumer engagement that go beyond marketing but are reimburseable and/or save them precious cash.