Keep it Simple Today and Take a Breath and think before you Decide to Fill out a PHR or not to Fill out a PHR: Okay, you've got your health insurance and one of the latest pushes is for you to fill out a PHR...a Personal Health Record. Remember your goals: The best medical care for the best price.
Microsoft is peddling personal health records and it is contracting with companies to provide this service. Active Health Management in NY and Microsoft have such a deal and you can read the publicity blah blah blah. Here's the pitch:
PHR's "Help people be more proactive about healthcare. The company built a solution for health plans that would consolidate members' health related information, and, more importantly, offer recommendations about practical steps that members and their physicians could take to head off potential problems....With the new solution, health plans can deliver clinical decision support while engendering member loyalty and reducing insurance costs."
Okay, take a breath. Sounds like we're being told we will receive better health care by filling out Personal Health Records. But what is the real sell? The sell is to health insurance companies, promising them greater input into "clinical decision support." Huh?
In other words, PHR's give insurance companies information that they can use in determining whether and how your benefits cover your medical condition. And as if this further empowerment of insurance company employees as medical service providers isn't enough, the real sell is right there: It will save insurance companies money.
So WHY are PHR's catching on at all? Because when it comes to CONSUMERS, Google is marketing this stuff the way the old Medic Alert bracelets were sold: "With Google Health, you manage your health information--not your health insurance plan or your employer. You can access your information anywhere, at any time." (See Spectrum Online, Google Gagga Over Personal Health Records). Sounds pretty reasonable, after all, I am a big supporter of Medic Alert bracelets that list your conditions and your medications, so what's different here?
First, PHR's are used by health insurance companies to manage your health in a cost effective way...without a guarantee that even a nickel's worth of savings achieved through PHR's will be passed onto the consumer doing the health insurance company's work for them, this is not an incentive for consumers.
Second, PHR's do not include a mandate that a doctor rely on the information within. In other words, if you obediently record that you've had a catscan, the doctor does NOT have to rely on that and can order a new one. In other words, as of now these records will NOT save consumers time, energy and money in medical testing.
Third, PHR's can include diagnostics where someone is misdiagnosed as having one ailment and is treated and then after that treatment fails the diagnosis is further narrowed down to the true ailment. Unfortunately, you now have a RECORD of both ailments.
In Medical News Today, March 12, 2008, Deborah Peel founder of Patient Privacy Rights stated that "Giving more information about yourself to your health insurer is probably the worst possible thing to do."
The same article in www.medicalnewstoday.com informs us that HIPAA (The Health Insurance Portablity and Accountability Act does NOT cover medical records placed online.
The Federal Government is FOR PHR's. After all, they are a management tool for health insurers and those who pay for medical services. The Centers for Medicare and Medicaid promises that "Personal Health Records will have stringent controls to protect the privacy and security of the information, and individuals will have control over who has access to the information."
Please note, we CURRENTLY have control over who sees our medical information but, look at your insurance claims forms: Every one of them requires that you forfeit your privacy as to the insurance company IF you want to obtain your plan coverage for medical services.
In its discussion of HIPAA, the State of Wisconsin explains the Federal Law and states: An insurance company cannot obtain your personal medical information without your written consent....an Authorization authorizing the company to obtain personal medical information in connection with a claim for benefits is valid for as long as your policy is in force."
The article continues that "you have the right to refuse an insurance company access to your personal medical information. However, doing so may result in the insurance company having insufficient information to determine eligibility for coverage, premium rates, or policy benefits." In other words, you can be denied if you don't forfeit your own privacy rights.
The ACLU is onto the problem though their activities are not significant to date. If you go to the ACLU website you can look under Medical Privacy and Electronic Records, from 7/22/2008. The article cites key concerns: Identity theft, accidental publication of patients' sensitive or embarrassing personal information, discriminatory review by insurance companies or potential employers, invasive direct marketing to patients or doctors, commercial resale or misuse of personal health information. The ACLU article includes proposed legislation that you can go to and support or not support based on your decision. Take the time and make your own opinion heard by visiting any of the websites identified above or others dealing with PHR's.
After taking a step back, and gathering more information, make your own best decision.
For me, PHR's are a tool that make it easier for health insurers to do what they do best, deny claims using patient information and thereby saving money that they never pass on to consumers in the form of refunds or lower premiums.
