Individuals Can Choose to Transfer PHR Information When They Change
Insurers
WASHINGTON, Dec. 13 /PRNewswire/ -- Consumers will have greater access
to the information they need to optimize their health and health care
thanks to a new personal health record (PHR) model being developed by
health insurance plans.
America's Health Insurance Plans (AHIP) and the Blue Cross and Blue
Shield Association (BCBSA) worked together to identify the core information
to include in PHRs, and have developed and pilot tested standards that
enable consumers to transfer PHR data when they change coverage. This
ensures that PHRs will be portable from health insurer to health insurer as
consumers have requested. Members of the two groups cover over 200 million
people.
The industry model PHR is a private, secure web-based tool maintained
by an insurer that contains a consumer's claims and administrative
information. PHRs enable individual patients and their designated
caregivers to view and manage health information and play a greater role in
their own health care.
As a result of insurance claims filed on behalf of consumers, insurers
have most information needed to provide PHRs, and are in a unique position
to build them for consumers in the near term. PHRs are distinct from
electronic health records, which providers use to store and manage detailed
clinical information. An estimated 70 million people have PHRs through
health insurers, with millions more scheduled for the service in 2007.
Physicians encouraged insurers to adopt a consistent set of core PHR
data. Health insurers will continue to innovate in the PHRs they develop,
but the goal is to incorporate core data elements into every PHR. These
elements include patient histories, medications, immunizations, allergies,
risks, plans of care, and other information that physicians identified as
the key data. The health insurance community has set a goal of
incorporating the core data elements and implementing the standards for
portability from a prior insurer to a new insurer by 2008.
"Efforts such as those by health insurance plans to provide consumers
with portable PHRs are a step forward in the national health IT agenda. We
welcome your continued work to achieve interoperable, consumer-centric
health information," said Robert M. Kolodner, MD, Interim National
Coordinator for Health Information Technology at HHS.
There is consensus among stakeholders that the widespread adoption of
health information technology will lead to safer, more effective health
care. Experts believe adoption of technology will reduce preventable
errors, such as medication errors, increase compliance with recommended
treatments, improve treatment for people with chronic disease, and
contribute to lower health care costs.
"We are continually looking to utilize new information technologies,
such as PHRs, to empower our members to receive the highest quality of
care. Developing a model PHR is critical for effective use of this powerful
tool by health care consumers," said William J. Marino, President and Chief
Executive Officer of Horizon BCBSNJ.
"Health plans will play a pivotal role in providing consumers with the
tools and information necessary to make well-informed health care
decisions, and PHRs may be one of our most important contributions to
helping improve health care in the U.S.," said Ronald A. Williams,
Chairman, CEO and President of Aetna. "PHRs can also simplify and
personalize a consumer's health care experience and encourage individuals
to take a more active role in their health," he said.
Good health care in the 21st century means having the right information
in the right hands at the right time. Individuals need real-time access to
health information that may be dispersed among a number of physicians,
hospitals, pharmacies, and other health care providers. But we are many
years away from having a system that is fully interoperable.
"Health insurance plans are in a unique position to make a contribution
through consumer-focused PHRs," said AHIP President and CEO Karen Ignagni.
"Until now, the information contained in PHRs has not been consistent -- a
concern that led several physician organizations to urge the industry to
identify the core data for PHR content -- or portable from health plan to
health plan," she said.
Health insurers worked closely with standards organizations to ensure
the health plan-based PHR is compatible with standards that are being
developed for the time when our health care system is fully interoperable.
According to BCBSA President and CEO Scott Serota, who represents the
industry on the federal America's Health Information Community, "we
undertook the project with the idea that we wanted our work to be in sync
with the Administration's priorities and a building block for future
efforts," he said. "PHRs built with these shared standards will go a long
way in creating a seamless and efficient health care system that truly
benefits the consumer."
The group also announced a pilot program in two regions of the country
with the National Health Council (NHC), whose members believe that PHRs are
critical to the needs of people with chronic conditions and disabilities,
who often must play a daily role in managing their health.
"The Council is enthusiastic about the prospect of working with AHIP
and BCBSA and their members to encourage greater use of PHRs, especially
among people with chronic conditions and disabilities, and to foster
greater appreciation of the role of PHRs in optimizing health," said Myrl
Weinberg, President of the NHC. "This patient-centered focus in health IT
may seem like an 'add-on' to the architecture of a system well underway,
but we believe that integrating this patient focus now is central to the
success of health IT," she said.
The industry also adopted a guideline that requires an individual's
approval before transferring PHR data from one insurer to another and
requires that the transfer take place after enrollment in the new plan.
Consumers have indicated that they favor this guideline.
America's Health Insurance Plans - Providing Health Benefits to More
Than 200 Million Americans
The Blue Cross and Blue Shield Association is made up of 39
independent, locally operated Blue Cross and Blue Shield companies that
collectively provide healthcare coverage for nearly 98 million Americans.
For more information on the Blue Cross and Blue Shield Association and its
member companies, please visit http://www.BCBS.com. For more information on
Blue Cross and Blue Shield Association's policy positions and the
healthcare debate, visit http://www.BCBSHealthIssues.com.
The National Health Council is a private, nonprofit organization of 115
national health-related organizations working to bring quality health care
to all people. Its core membership includes 50 of the nation's leading
voluntary health agencies representing approximately 100 million people
with chronic diseases and/or disabilities. Other Council members include
professional and membership associations, nonprofit organizations with an
interest in health, and major pharmaceutical and biotechnology companies.
The Council serves as a place for diverse health-related groups to build
consensus with a focus on patients and their needs.
SOURCE America's Health Insurance Plans
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Related links:
http://www.ahip.org
http://www.BCBS.com http://www.BCBSHealthIssues.com
CONTACT:
Susan Pisano of AHIP, +1-202-778-3245; John
Parker of BCBSA, +1-202-626-4818; or Kirk Rafdal of NHC,
+1-202-973-0550
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