Eyeing the Personal Health Portal

Online shopping: awesome. Online banking: terrific. Search: incredibly useful — even the ads.

Everything seems to go better on the Internet, where information is quickly updated, accessible
from any computer 24 hours a day. The next wave of Internet enabling is coming to your family doctor and your local hospital.

Instead of playing phone tag with your doctor for days — or not getting a callback at all — you’ll be able to simply log on and read your test results.

But to make this happen, the nation’s health care system must stop shuffling papers and undergo a transformation similar to the e-business boom of the late 1990s.

E-business applications opened up new possibilities for companies, as it made their operations more efficient and provided new insight into their processes. At the same time, the era of e-business enriched hardware and software vendors, as well as professional services firms, as companies bought massive amounts of servers and pricey “solutions.”

That’s one reason that Microsoft (NASDAQ:MSFT) and Google (NASDAQ:GOOG) have made big moves into health care.

In October 2007, Microsoft announced HealthVault. Still in beta, the service features health information from professional sources, with special optimized search.

Rather than providing a standardized personal health record, Microsoft has taken the platform approach, enabling people to create customized profiles or records. It’s working with the Mayo Clinic to build tools to let people manage their own health.

Users can store information from medical devices such as blood pressure monitors or blood glucose readers. The plan is to eventually let consumers collect, store and share health information with hospitals and physicians while maintaining the privacy and security of their data. In addition, partners will be able to build applications on the HealthVault platform.

Google Health launched in February, announcing a partnership with Cleveland Clinic, an academic medical center that treats approximately 3 million patients from around the world each year.

A pilot program will test secure exchange of patient medical data such as prescriptions, conditions and allergies between the Cleveland Clinic’s electronic personal health record system and a secure Google profile in a live delivery setting.

The ultimate goal of the initiative is to give patients the ability to interact with multiple physicians, health care providers and pharmacies in a network that spans the United States.

[cob:Special_Report]Google did not provide comment on the initiative at press time.

The benefits of having a central repository in which consumers can store their personal health records, or PHRs, are compelling. “The patient is forced to be the vehicle for information exchange,” said C. Martin Harris, M.D., CIO of the Cleveland Clinic and leader of the hospital’s work with Google.

But even patients who have copies of their medical records may forget to bring them to the new doctor. If they’re admitted to the emergency room and unable to communicate, their health status is a mystery and doctors have to start from scratch.

Harris says a nationwide, 24/7 portal for PHRs accessible by providers only with a consumer’s consent would reduce errors, improve health and save money.


Moving beyond paper

But the nation’s health care system, as well as the practices of its providers, is mired in old-fashioned paperwork. It may be much more resistant to change than a manufacturer’s supply chain.

“The Cleveland Clinic does not have the ability to build a connection to every hospital, pharmacy and doctor in the country; Google does,” Harris said. But Google has found an unusual partner in Cleveland Clinic.

The medical center, comprising 18,000 physicians, a 1,000-bed medical center and 10 other community hospitals, has been transforming its operations for seven years — way ahead of the curve. Five years ago, it launched MyPractice, its electronic PHR system. MyPractice is now used by all health professionals when caring for patients.

Then, three years ago, it added MyChart, an Internet portal that lets patients access their information from anywhere.

“We wanted to get information directly in the hands of patients and to be able to provide that information in the convenience of their home,” Harris said. “The patient no longer has to be their own medical historian. They can simply go online and look it up.”

Now more than 120,000 patients use MyChart. It offers more than a look at the medical center’s records. Cleveland Clinic’s physicians have written a set of rules run against each patient to create a personalized health maintenance schedule for that person.

Patients can enter information from their homes. For example, the system could prompt a 50-year-old woman to make appointments for annual mammograms. A diabetic can enter daily blood glucose levels into the system, instead of having to write them down on a piece of paper — and perhaps forget to bring the paper to the next office visit. The hospital now is doing a study of diabetic patients to see whether MyCharts will improve their health.

The Federal government has been promoting the idea of a nationwide electronic PHR system for years. The proposed National Health Information Network, under the guidance of the Department of Health and Human Services, takes the approach of letting states or regions build their own regional health information organizations. Then, they’ll be connected — somehow.

The Department of Health and Human Services did not make a spokesperson available.

The president’s goal is making electronic medical records available for most Americans by 2014.

However, as the Health Care Information and Management Systems Society points out, “The concept of NHIN requires extensive collaboration by a diverse set of stakeholders.” Unless every provider uses the same standards for data, it could be impossible for regions to exchange information reliably.

[cob:Pull_Quote]Said Harris, “In an absence of an integrator the size of Google or Microsoft, you could build out that exchange in your region, but as soon as someone moves out of that region, it’s useless.”

Meanwhile, just as businesspeople began using consumer applications such as browsers and Web mail on their office computers before their IT departments got enterprise systems up and running, consumers may take their health information into their own hands thanks to Google or Microsoft.

The eCleveland Clinic initiative will transform health care the way Web-based applications and social media have changed shopping, entertainment and communication, Harris says. “Patients are directly engaged and actively involved in maintaining their own health. It allows them to interact with our organization in a more typical 21st-century model — online.”

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