Last year, Google Health, a cloud-based Personal Health Record (PHR) was shut down, and Microsoft’s own PHR, Health Vault, has morphed from a consumer offering to a service offered to providers. And, in spite of the next phases of Meaningful Use requiring patient portals integrated into EHRs to increase engagement and improve outcomes (reference Sept. 24 Hello Health blog post), there has been a chorus of critics proclaiming the PHR dead in the water. Patients will never adopt it, no one will pay that close attention to their health, they say. They point to the limited adoption of all sorts of consumer-directed health tools, from fitness monitors to PHRs as evidence.
Yet, in August this year, Kaiser Permanente announced that almost two thirds of the 3 million members who had access to its PHR, My Health Manager, had not only signed on but were also using it, to the online tune of 1 million secure e-mails and 2.5 million lab test results per month. Sounds like successful adoption to me.
So what’s their secret sauce?
Actually, there’s no magic involved, just common sense. Kaiser has ensured that the member’s PHR is seamlessly linked to the EHR maintained by the providers for the member. It has spent considerable time designing My Health Manager to be simple to use, although it certainly breaks no new ground from an online experience perspective. It has enabled scheduling, secure e-mails, value-added information (especially important for chronic disease management), prescription refills and viewing test results online. All pretty standard stuff, really. No video calls. No real-time biosensor monitors.
What gives it the power is the PHR’s readily-apparent integration into the relationship established by the member with the Kaiser care team. It is collaborative and meaningful. It’s something of real value provided to the patient. Ah, that’s the problem for most patients and physicians, isn’t it? The Kaiser providers are capitated, which means there’s no financial penalty for providing online advice. That’s not the case for most primary care practices, even if patients value it.
According to a poll of 2,300 individuals conducted by Harris Research just this past summer, well over half consider electronic access to their health information, the ability to schedule online and e-mail access important. At Kaiser, in fact, the availability of these features has led to almost three times the patient retention rate.
The challenge we see is that the first response of physicians who hear about such demands (and the services that satisfy these demands) is “How can I provide it if it’s not something I get paid for?” I’d like to see the question evolve to “what can I do differently so that I can provide these services?”
We’ve been developing business models that provide new sources of revenue for physicians, revenue that fills the voids of uncompensated care, priced at points that are accessible to any patient. And the experience for the physicians and patients in these new revenue models is revelatory – patients love the engagement and physicians are happy to provide what are no longer uncompensated services.
So, go ahead. Ask your patients what they’d like to see in your practice. You won’t be surprised by their answers. But you might surprise them by actually giving them what they want.