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The Consumer Role Post Stimulus

by John Moore | May 28, 2009

HCcostcutCartoonAfter the $36B+ has been spent on what is hoped is the digitization of the healthcare sector via adoption of EHRs, what will be the consumer role?  That was the question put to four speakers yesterday as part of the eHealth Initiative webcast that Chilmark Research participated in yesterday. Other speakers included: Phil Marshall of WebMD, Eva Powell of the National Partnership for Women & Families, and George Scriban of Microsoft.

With only 10 minutes allotted to each speaker, it is not like we had sufficient time to dive deeply into the issues, but simply to give some flavor as to what might be expected in the future, post-Stimulus.  Currently, the legislation as well as all discussion to date regarding the ARRA funding for EHR adoption has been eerily silent on what will all of this funding mean to the average consumer/tax-payer.  How will they directly benefit?  Will it be through lower costs and subsequently insurance premiums? Will it be through better quality of care? Might it be convenience?  Hard to say but one thing can be said at this point: Sadly, HHS, has spent very little effort in articulating the value proposition of the planned HIT Stimulus spending for the tax-payer.  If HHS is not careful, this may come back to haunt them and more broadly, the Obama Administration further down the road.

Following is the slide presentation that Chilmark Research used yesterday where we gave our own views on the role the consumer will play post-stimulus.  Not exactly the most far-reaching of projections, simply too many variables at this early date.

[slideshare id=1497885&doc=ehimay09-090527161742-phpapp02]

During the Q&A, what struck me was the relative simplicity of the questions and to some extent the lack of in-depth knowledge on some of the critical consumer issues,  particularly with regards to PHRs.  Following is a set of questions that came through from one of the Blue Plans.  If they have these types of questions, quite sure many others do as well.

Ques: What types of metrics are available to track PHR usage?

Ans: Currently, there is no consistency on what metrics are tracked in a PHR.  Most often, metrics used are defined by the sponsor and may include accessing record, taking an action, responding to an alert, etc.  Ill-defined as market is still immature.

· Ques: What are the most used features in the PHR?

Ans: Depends on who is sponsoring the PHR. Employer/payer sponsored PHRs often have an HRA with incentives tied to it to encourage completion.  Increasingly, these PHRs have tie-ins to HSAs and pricing data to assist in purchasing decisions. Provider PHRs depend on level of transactional services provided. The most successful PHR today in North America is the one at Kaiser-Permanente and consumers use the following: Access Labs, Schedule Appointments, Request Rx Refills and have eConsults.  Consumer sponsored PHRs are minuscule part of market, less than 2% by our estimates.

· Ques: What percentage of today’s PHRs are pre-populated with data?

Ans: Data comes in many forms, claims, PBM, clinical, admin, images, labs, etc. Most sponsored PHRs have some pre-populated data. Thus Chilmark’s guess is ~90% but warning, amount & type of data is HIGHLY variable.

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