AHIP, BCBSA Issue Standards For Personal Health Records

America's Health Insurance Plans and the Blue Cross Blue Shield Association on Wednesday announced standards that can be used by insurers to offer personal health records -- patient-controlled medical records that are stored online and can be transferred among insurers, CQ HealthBeat reports. AHIP and BCBSA said they would like all of their members to offer PHRs by the end of 2008. Insurers are in a unique position to provide PHRs because they handle patient information in a variety of medical settings, the groups said. The standards call for insurers to automatically collect patient information in several areas and enter the data into the PHR. The information would include:
Records of visits to hospitals and physician offices;

Diagnoses, procedures and drugs related to those visits;

Medication history and pharmacy information;

Insurance benefits, copayments, deductibles and eligibility status;

Names of clinicians and facilities that have provided care; and

Reminders, orders or recommendations from care management programs used by the patient.

The standards also call for insurers to allow patients to voluntarily enter information about their family medical history; blood type; height and weight; immunization records; history of allergies or adverse reactions; advance directives; and use of alcohol, tobacco and illicit substances. Some insurers would add additional features. For example, Aetna CEO Ron Williams said the company would add a "Care Engine" feature, which would scan a patient's records and identify "opportunities to improve care." The groups said information in the PHRs would be transferred to a new insurer only after a patient was enrolled in the new plan and had provided consent. This would prevent data from being used by an insurer to deny or limit coverage, according to the groups.

Comments
AHIP and BCBSA in a statement said, "Personal health information is often dispersed piecemeal among a number of physicians, hospitals, pharmacies and other health care providers," which can result in "preventable medical errors, inefficient and inappropriate care, and duplication of tests and procedures." Michael Zamore, an aide to Rep. Patrick Kennedy (D-R.I.), who supports increased use of health care information technology, said, "I think it's a big step in the right direction. People are not going to want to invest the time to build the records up if they go poof when they switch plans." However, Zamore added, "I have some question whether PHRs tethered to the health plan are going to be the big market winner" (Reichard, CQ HealthBeat, 12/13).

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