MICROSOFT TO LAUNCH CONSUMER HEALTHCARE RECORD SERVICE

Software operating system monolith Microsoft just announced the launch of HealthVault, a “patient-driven” healthcare records storage system.

In a New York Times Article from October 5th entitled “Microsoft Offers System to Track Health Records”:

Microsoft is starting its long-anticipated drive into the consumer health care market by offering free personal health records on the Web and pursuing a strategy that borrows from the company’s successful formula in personal computer software.

The venture by Microsoft, which is called HealthVault and was announced yesterday in Washington, comes after two years spent building a team, expertise and technology. In recent months, Microsoft managers have met with many potential partners, including hospitals, disease-prevention organizations and health care companies.

BIT BUCKET OR HOPE CHEST?

HealthVault is a secure database where individuals may store their health records and perform healthcare-related web queries. HealthVault also permits individuals to specify who may have access to their health records.

The accounts are free for individuals and HealthVault can be accessed at www.healthvault.com. The company hopes that individuals will give doctors, clinics and hospitals permission to submit information like medicines prescribed and data on blood pressure and cholesterol levels.

Microsoft also hopes to develop partnerships with healthcare providers to automatically direct patient records to such patient’s HealthVault. Microsoft states that it has developed projects with a handful of healthcare organizations.

CONSUMER DRIVEN: ALL REVVED UP, NOWHERE TO GO.

The Author has done consulting work for healthcare information organizations and is familiar with some successful Regional Health Information Organizations (RIOs). Large healthcare information networks centralize patient information and allow healthcare providers to access a combined, logically structured patient record. This patient record can include test results, diagnoses, discharge summaries, X-rays, prescription records, and other relevant information. They help providers coordinate care, speed up the transfer of information, and can avoid duplication of tests and other interventions.

For example, if a physician orders a lab test and the results are mailed or faxed, the physician may not have the results when she or he needs such results. In that case, the physician may reorder the test, incurring a duplicate expense.

Like all information networks, they become more valuable as they include the most relevant users-hospitals, labs, physicians and other providers.

Such healthcare information networks and RIOs do not organically appear. They require money, commitment from stakeholders, robust databases and query mechanisms, complex algorithms to identify patients, and authenticating mechanisms to make sure that unauthorized individuals do not obtain improper access to information.

And more importantly, they require physician and provider commitment and training.

DOCTOR, PLEASE GO TO MY WEBSITE AND DOWNLOAD MY MEDICAL RECORDS.

Health information networks, at least to date, are created for the providers (and sometimes for the payors), not the patients. They are the stakeholders using the networks and they are the stakeholders deriving value, on behalf of the patient, from the network.

Oh, and one more thing. Under the laws of most states, and functionally under HIPAA (Health Information Privacy and Accountability Act), the providers OWN the medical records, not the patients. The patients have varying degrees of rights in and to the records (such as the right to view them, copy them, perhaps amend them). But the records are the property of providers.

These ownership issues are not insurmountable, but they will give healthcare lawyers lots of billable hours thinking and drafting through the patent and latent issues.

Some providers will communicate with patients via email. But will providers rely on a patient created set of files to coordinate and provide care for a patient? Several issues emerge.

First, can or should the provider rely on the accuracy of the record? There must be an authentication mechanism in place to assure their accuracy. If there is no guarantee that the record is authentic, the provider would be ill-advised to act upon such a record. Many records are stored in PDF format. But what if the patient has a PDF editor and is willing to use it?

Secondly, are the patient’s records complete? Do they provide enough information for the provider to properly treat the patient? Or has the patient intentionally concealed information from the provider? Sometimes patients will not provide full information for various reasons such as embarrassment or the sensitive nature of a condition. Sometimes patients simply do not want their provider to know that they are seeing another provider, or that they have sought a second opinion.

Additionally, and perhaps most importantly, are the records systematically organized and accessible? Are they contained in a coherent data schema that providers understand, or does the record file structure resemble a shoebox of receipts stashed in the bedroom closet? If the records are not presented in a coherent and easily accessible fashion, providers will likely not use the information.

STILL, HealthVault IS A LEAP FORWARD.

Despite touting itself as the owner of the most technologically advanced healthcare system in the world, America lags in the adoption of computerized medical records. A recent study by the Commonwealth Fund shows the US lagging in the use of computerized records. So almost anything will help.

It should also be noted that the adoption and use of computerized records and health information networks vary widely across the nation. Some cities, such as Indianapolis and the surrounding counties, have broad and effective healthcare information networks. Other cities, and particularly rural areas, lag far behind.

Does HealthVault have a future? Yes, perhaps a limited one. Some patients will post their records, and perhaps some providers will share records with HealthVault accounts. Some providers may occasionally consult such records. And it may put more fax machines out to pasture. But don’t look for any RIOs to be running for the egresses.

HealthVault is likely to be more than a bit bucket, but far less than a brilliant health information breakthrough.

EVERYTHING WE NEED TO KNOW IS STORED ON FLASHDRIVES IN THE DESERT OF THE REAL!