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Live from HFMA — PHR Proponents & Their Dicey Data Dilemma

June 24, 2008
by aguerra
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The future of healthcare is all about empowering the consumer with information and, subsequently, responsibility, according to Steve Case, the founder of AOL and, more recently, Revolution Health (a fact Mr. Case couldn’t help but continually remind us during the HFMA annual conference keynote this morning in Las Vegas).

The consumer, the consumer, data, data, PHRs, PHRs.

It all seems to make sense, and it may all very well work out that the consumers will be the main manager of their own health, stopping in with physicians from time to time for some advice, but ultimately taking the reins. Consumers may wind up aggregating their doctor-provided data with information acquired from other sources, such as WebMD or Consumer Reports, ultimately making their own decisions based on quality and price.

But lately I’ve been thinking that — short of those with chronic conditions who understand the pain of going to multiple specialists, each of which has no idea what the last one ordered — most American’s probably aren’t interested in aggregating their own health information. It just seems like too much work for too little concrete benefit.

Sure, we’d love it if the ER doc knew our medical history, but from my discussions with CIOs, there’s no way they’re ever going to let such data into their systems, let alone have physicians act on it. Could that be the ultimate undoing of the PHR?

In fact, CIOs I’ve spoken with aren’t even interested in accepting data from associated physician practices into their systems. They’ll underwrite some EMR technology to tie in the docs, they’ll even allow hospital data to flow out into the practices. But allow physician data into the inpatient files? No way, no chance, no how. Think about taking medical action off someone else’s data and the liability issues become clear right away. I suspect a quick chat with the hospital’s chief counsel would confirm all this.

CIOs are super protective over their data because that data becomes the basis of actual medical care — the difference between life and death. In fact, HCI’s upcoming August cover story package will be on just this type of business intelligence — mining all that data so it can be turned into reports clinicians and hospital finance executives can actually use. If you think for one second they’re going to let some potential bad apples spoil the whole bunch, you’re mistaken.

What does that mean for the PHR revolution and Mr. Case’s new ventures? I think it means tread slowly, tread lightly and don’t expect hospital CIOs join the revolution anytime soon.

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