Members of a federal advisory panel working to promote personal health records met Thursday to develop final recommendations prior to a key Oct. 31 meeting of the panels parent organization, the American Health Information Community.
A draft of recommendations by the consumer-empowerment work group to AHIC based on discussions in the meeting will be written up by committee member Ross Martin, a physician and director of business technology at Pfizer, and HHS staffer Kelly Cronin, who heads the office of programs and coordination within the Office of the National Coordinator for Health Information Technology. The draft will be circulated among committee members for final comments before final recommendations are sent on to AHIC, which was created last year by HHS Secretary Mike Leavitt to offer healthcare IT policy recommendations.
The consumer-empowerment work group was one of the original four workgroups specified by AHIC in November 2005 -- there are six workgroups now with a seventh, on the interface of IT and genetics, likely to be created. The initial charge of the consumer empowerment work group was to make recommendations on promoting PHRs, and specifically, to make recommendations on how PHRs could be loaded up with a patients medication history and demographic data to facilitate patient registration.
Patients could place the information in PHRs themselves and many vendors have such systems on the market, but questions were raised about whether patients would want to -- or be able to -- place their prescription records and other healthcare information in their systems themselves.
Earlier, the committee ranked PHRs by their existing business models -- tethered PHRs that were an extension of an IT system of providers, such as physician groups or hospitals; those provided by payers; those offered by employers; and those offered by various independent business entities. The group indicated that a tethered PHR was preferred because the provider connection could facilitate automatic data transfer.
Part of the discussion Thursday centered on other data sources with payers and pharmacy benefits managers mentioned as likely providers.
Work group member J.P. Little, chief operating officer at RxHub, a data transmission consortium formed by three large PBMs and a potential data source for PHRs, offered, a bit of dissenting opinion on how data needs to get into PHRs. At present, he said, There is no business model that would support magically populating these systems.
The way that it works at RxHub, Little said, is that business entities contract for access to medication histories from its member pharmacy benefit manager members.
The PBMs are not in the business of massively sending out content to PHRs or even EMRs, Little said.
Work-group member Kathleen Mahan, who works in product management at SureScripts, the for-profit electronic-prescribing network established by two retail pharmacy trade associations, said she would totally agree with J.P. We are going to be doing this type of push of data in the next month or two into a PHR, but the business model is not there yet.
Another key issue discussed was integrating personal health records, which are primarily patient/consumer oriented, with electronic medical records systems used by hospitals, physicians and other providers. This moved the discussion to communication standards and the unfinished work on a compromise between rival products of two standards-development organizations, Health Level 7, with its Clinical Document Architecture/Care Record Summary, and ASTM International, the developer along with the Massachusetts Medical Society and the Health Information and Management Systems Society of the Continuity of Care Record. The compromise standard, the Continuity of Care Document, is targeted for release by mid-2007, though the CCR is already supported by more than 30 EMR systems developers.
Little said, The CCR standard is really workable and could be in use today, but Martin, who has worked with Health Level 7 committees in the past, said that while he is certainly supportive of CCR/CCA, whichever one gets us to that point, its not our task to pick standards, so dont be offended if a standard is not specified in the groups recommendations. Its not our job. Thats HITSPs job, he said, referring to the Health Information Technology Standards Panel working under a HHS contract with the American National Standards Institute.
The next meeting of the consumer empowerment work group is set for Nov. 6.