Implications of the Kaiser-Microsoft PHR Deal

A report of a new partnership between Kaiser Permanente and Microsoft regarding personal health records (PHRs) (see: Kaiser Backs Microsoft Patient-Data Plan) raises a set of interesting issues. Below is an excerpt from the article (boldface emphasis  mine):

Kaiser Permanente, the nation’s largest nonprofit health maintenance organization, is endorsing the drive toward consumer-controlled personal health records in a partnership with Microsoft. The partnership...will begin with a pilot project open to Kaiser’s 156,000 employees, which will run until November. If successful, the product linking Kaiser’s patient information with Microsoft’s Health Vault personal health-record service will be offered to Kaiser’s 8.7 million members in nine states and the District of Columbia....There are several companies offering personal health records on the Web, but the big new players are Microsoft, which entered the field last October, and Google, which came in last month....[T]he Microsoft and Google health offerings give individuals control of their own health records, as well as responsibility for them. Today, most electronic health records are maintained by health providers and insurers, allowing individuals access to their records through the Web. But those records are typically controlled by the institutions, and are not portable when a person changes insurers or health providers or moves to another part of the country. Both Microsoft and Google have previously announced collaborative pilot projects with other health providers. For Microsoft, they include the Mayo Clinic and New York-Presbyterian Hospital. For Google, they include the Cleveland Clinic and Beth Israel Deaconess Medical Center.

I have posted a number of previous notes about the Kaiser Health System, including its prolonged roll-out of the Epic EMR system, called HealthConnect, across its entire chain of hospitals with particular emphasis on the massive cost of the project (see the most recent of them: An Update on the Kaiser HealthConnect Project). Kaiser admits to a cost thus far for the EMR of $4 billion plus $1 billion yearly for maintenance. Only 13 of the 36 Kaiser hospitals have gone live with the inpatient EMR system thus far.

I have also posted a number of blog notes about personal health records (PHRs) of both the tethered and untethered varieties. Below is a quote from a recent note about HIMSS, PHRs, Microsoft's Health Vault, and Google Health (see: HIMSS President Slams PHRs: I Wonder Why?):

What's really worries [HIMSS CEO Steve] Leiber and the EMR vendors, from whom he takes his orders, is the likes of Microsoft's HeathVault and Google Health. Note that the latter company has recently created a partnership with the Cleveland Clinic (see: Google CEO Discusses New Partnership with Cleveland Clinic). What Leiber and the EMR companies fear is that Microsoft and Google will launch a fully-featured EMR/PHR combo that will deliver both value and functionality.

The recent Kaiser/Microsoft announcement brings into play three critical questions that I will summarize below:

1. Who owns/controls patient clinical information: (1) the health system that creates the information; (2) the vendor of the electronic medical record deployed within a health system such as Kaiser; or (3) the patients on whose behalf electronic medical records are generated and who pay for them, either directly or indirectly through health insurance plans? My personal vote on this question is the patients.
2. To what extent is a health system like Kaiser limited in its ability to replicate clinical information managed by an EMR supplied by a vendor such as Epic to a free untethered PHR like Health Vault? Epic has its own tethered PHR product called MyChart that It sells to its hospital clients such as Kaiser (see: The Revolution Will Not be Televised). Kaiser currently provides a tethered PHR to its patients, My Health Manager, which is based on the MyChart patient portal (see: HealthVault Signs on Kaiser). I personally think that PHRs should be free, untethered, and should also contain most of the information present in hospital and physician office electronic records (see: HIMSS President Slams PHRs: I Wonder Why?).
3. How will Epic react to the Kaiser/Microsoft announcement? Clearly, they have a lot of skin in the game. They can't be happy about this turn of events. It's hard to imagine a future scenario with Kaiser that works totally in their favor with Microsoft sitting at the table.
   

Comments

[electronic medical records]

Kaiser Permanente has millions of health plan members, with thousands of employees, physicians, medical centers and medical offices with annual operating revenues earned in billions.Thanks for the information.

[Scott Smith]

I read with great interest your blog about electronic medical records. MyMedicalRecords.com (MMR) is an advanced patient health record and an Integrated Service Provider on Google Health.

Using MMR, complete patient records can be easily faxed, voiced, or uploaded into a password-secured, web-based account. An emergency log-in feature also allows access to your critical medical information in the event of an emergency, and it has a drug interaction database for prescriptions, as well as many other features.

Perhaps you and your readers would like to test drive MMR by signing up for 30 days free using the promotion code TRYMMR.
Scott Smith
MyMedicalRecords.com
ssmith2@mmrmail.com
10100 Santa Monica Blvd #430
Los Angeles CA 90069
888-808-4667 ext. 123