Personal Health Records Miss Mark

So-called personal health records are no closer to being reality than they were 10 years ago, in part because patients perceive little or no benefit to them, a recent industry white paper concludes.

"The PHR model needs to continue to evolve from a business model that largely benefits providers, payers and employers to one that is aligned with patients' needs and integrated with their lifestyle," say Jason Fortin and Erica Drazen of CSC Global Healthcare Sector's applied research arm.

A PHR should be comprehensive, interactive, patient-controlled and secure, the authors say, but no records now on the market provide all four. Google, which had sought to be a major provider of personal health records, announced last month that it would pull the plug on its PHR project, Google Health.

The market is fragmented into multiple PHR models, they say. Almost all are either payer-populated, with employers or insurers entering insurance claim information; provider-populated, with medical practices or hospitals entering clinical or financial data; or "untethered / patient-populated," with the patient manually entering information or authorizing data entry by third parties including insurers, medical providers and pharmacies.

"Adoption by consumers remains limited and current activity consists largely of niche uses of silos of information," according to the report. Studies suggest no more than one in 10 patients has a PHR.

There are exceptions. About 60 percent of eligible Kaiser Permanente patients have signed up for Kaiser's version of a provider-populated PHR. And large insurers and employers, including Wal-Mart, are beginning to make payer-populated PHRs available to employees.

For "any kind of true PHR" to make it to market, several changes are needed, the authors conclude:

• Clinical information must be available electronically from the vast majority of providers.
• Both patients and providers need to think of PHRs as more than just information repositories.
• PHR use needs to trigger behavioral changes.