PHRs model by Blue Cross Insurance

High quality health care today simply means having the right information in the right hands and at the right time. You may be an individual or a family, every body need concurrent access to health care information that might be discrete among a number of physicians, hospitals, pharmacies, and other health care providers. But in fact we are many years away from the system that are fully interoperable. Consumers would have superior access to the health care information they require to optimize their health and health care thanks to a new personal health record (PHR) model being urbanized by Blue cross health insurance plans.

America's Health Insurance Plans (AHIP) and the Blue Cross and Blue Shield Association (BCBSA) worked jointly to recognize the core health care information to comprise in PHRs, and have urbanized and pilot tested standards, which allow consumers to move PHR data when they actually change their coverage. This ensures that PHRs would surely be portable from health insurer to health insurer as customers have requested. Members of the two teams cover about 200 million people.

The industry model PHR by Blue cross insurance is in fact private, secure web-based tool preserved by an insurer, which contains a consumer's claims and organizational information. PHRs allow individual patients and their chosen caregivers to look and manage health care information and play a better role in their own health care.

Consequently of health insurance claims filed on behalf of consumers, insurers have most information required to give PHRs, and are in an exclusive position to build them for customers in the near term. PHRs are different from the electronic health records, which providers normally use to store and run detailed clinical information. A projected 75 million people have PHRs throughout health insurers, with millions more planned for the service during 2007.

Physicians tend to encourage insurers to accept a reliable set of core PHR data. Health insurers would carry on innovating in the PHRs they expand, but the aim is to slot in core data elements into every PHR. These elements comprise patient histories, medications, immunizations, allergies, risks, plans of care, and much other information, which physicians recognized as the key data. The health insurance groups of people have set an objective of incorporating the core data elements and implement the standards for portability from a previous insurer to a new insurer by 2008.

Posted by: usha rani Posted on: March 19, 2007


dpeelmd said...

Americans are crazy to use PHRs offered by BCBS or other insurers because those PHRs are all designed for data mining and designed to evade the strong state laws, tort law, common law, and longstanding ethical protections that give consumers control of access to their other "medical" records.

PHRs offered by most technology vendors are no better than the ones insurers offer, because they too are designed to evade the definition of "medical records". That way these PHRs can be data mined by both the software vendors and users. Most PHR vendors illegally use and sell personal healthdata entered into the PHR as their business model. This is illegal even if the vendor claims that only de-identified, aggregated data are sold. De-identified data is easily re-identified.

There are a few PHRs that cannot be data mined. Tolven makes one.

Finally, the idea that insurers have the most useful data about consumer health to populate PHRs is simply false. Our doctors and other health professionals have the most critical and useful data about our health, NOT insurers.

You can no more tell about the quality of healthcare from looking at claims data than you can tell how good the food is at a restaurant from the looking at the bill (paraphrasing Homer Ladon, MD).

Your readers should check out if they want to understand how HIT has eliminated their rights to health privacy.

Deborah C. Peel, MD
Founder and Chair
Patient Privacy Rights

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