On the surface, the CMS recent announcement that it will launch a pilot project for personal health records in two Western states seems like another example of promoting consumer-driven healthcare. But the decision has one health information technology expert wondering if this project is the federal governments way of scaling back on its more ambitious electronic health record plan that began in 2004 when President Bush directed the government to create a national health information network within 10 years.
Earlier this month, the CMS said it will begin a pilot program in Arizona and Utah to determine if PHRs improve health outcomes and lower costs. During the programwhich will run from January to December 2009eligible Medicare beneficiaries will choose from several PHR tools and have up to two years of their data transferred into their individual record. The process will be managed by Noridian Administrative Services, Medicares administrative contractor.
There are some positive aspects to the pilot program, according to Nicolas Terry, a law professor and senior associate dean for faculty at the St. Louis University School of Law. These include giving patients more control over their health records and allowing them to share the responsibility for data with the CMS. But PHRs are not without their flaws, Terry said. For one thing, physicians and other health professionals are paid to keep records complete and up-to-date, but its unclear if patientsmany of whom are, as Terry described, non-medicalwill maintain the same kind of record purity.
You have to ask why CMS is doing this? Terry said. One possible answer: Is this a sign that the grand design is not going anywhere, so they are moving to a more modest, patient-centric, disaggregated model? But another explanationand I think this is implicit in what CMS is doingis to further design consumer-directed healthcare, he said, adding that such a move will essentially leave decisions about healthcare spending and services to patients.
The program is similar to the one the CMS launched in South Carolina in early April, which is also expected to last one year. Noridian began soliciting vendors for the Arizona and Utah project on Aug. 8, and vendors have until Sept. 8 to submit their applications.