Free EHRs: Where Does the Data Go?

A number of myths have been circulated this past year about cloud-based EHR (electronic health records) systems — especially free cloud-based systems like Hello Health’s. Supposedly, there are hidden costs involved. And, it’s been claimed, these systems may have conflict-of-interest ties to the data that they disseminate.

It is claimed that physicians using free systems ask their patients to pay a fee to get special, preferred-access “concierge model” services from them that allegedly are unavailable to patients who don’t pay such fees. Because the systems are free for participating physicians, the implication is that this is a disreputable arrangement.

Finally, the suggestion has been made that because Hello Health doesn’t state on our website that we don’t sell our data to third parties, the data isn’t really owned by the users and is being made available for some sinister purposes by entities outside of our system. Noting that our privacy policy says that the data we collect can be used for research or to send customers product news and surveys, accusers believe free EHRs are actually selling patient data to drug companies and researchers.

So, let’s clear the air and dispel some misconceptions.

First, many of the free EHRs for small physician practices – like Hello Health — are cloud-based, but they don’t all have the same business model. Unlike some of our competitors, Hello Health doesn’t rely on paid advertising to keep our system free. Nor do we provide our EHR as a carrot so that we can then charge a high monthly license fee to use our practice management solution or other services. Rather, ours is a subscription-based model, where patients pay a small fee for use of PortalConnect, our patient portal. Patients get on-demand, online access to their lab reports and notes from their recent visit, and they can also access practitioners directly and securely through our secure messaging and video chat features. We split revenue from patient subscriptions with our physician clients, and in effect support the independent practice’s ongoing quest to remain independent through financial viability. Counter to what has been suggested, Hello Health does not give special treatment to those patients who subscribe to Hello Health and lesser care to those who don’t. There are no special reserved appointment slots for subscribing patients; they just get the added convenience and flexibility of scheduling appointments online or contacting the participant physician through the Hello Health portal.

And, we do not sell the data in our system or use it for commercial purposes — ever.

But that doesn’t necessarily mean that physicians and patients should continue to be overly protective about that data. Data that exists in aggregated format, otherwise known as “big data,” can be extremely valuable in health care. The data for any one patient typically comes from many sources, including hospitals, laboratories, physician offices and payers. When data is digitized in modern health information technology systems like EHRs, it becomes easier to consolidate and then normalize so that it can be used to improve outcomes. As disparate systems become more interoperable and clinical data becomes less siloed, this will be simplified even further. For instance, emerging population health management care models work when data from a broad population of patients is collected from various sources and stratified to target at-risk groups to prevent certain health conditions.  Similarly, the move toward evidence-based medicine emphasizes data analysis in clinical decision making. The big data trend even carries over to the public health arena, as government agencies track data patterns to proactively identify disease outbreaks, bioterrorism, or other public health risks. All of these examples are to the advantage of patients and doctors alike. And big data is here to stay. Whether we like it or not, we’ll rely on analytics more than ever in the near future as payers, providers and vendors will need to work together to meet government mandates for accountable care, where the emphasis is on lowering costs and boosting quality

The data that Hello Health and other free EHR systems collect and distribute has tremendous potential for improving the administration and quality of health care. As long as user data within an EHR is handled responsibly and in compliance with regulations, like HIPAA (the Health Information Portability and Accountability Act), that govern the use of protected, personal health information, we should embrace that potential. Because Hello Health strictly adheres to all of those regulations, we are vigilant stewards of the data we collect.

About the Author
Nat Findlay

Nat Findlay is the Founder and CEO of Hello Health, the EHR that offers tools to promote profitability for today’s independent medical practice.