PHRs: Where We've Been, Where We're Going (Text Version) Slide presentation from the AHRQ 2009 conference. On September 14, 2009, John Moore made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (6.5 MB) (Plugin Software Help).Slide 1 PHRs: Where We've Been, Where We're GoingWhere We've Been, Where We're GoingBy: John Moore, Managing PartnerJohn@ChilmarkResearch.com Slide 2 Three Take-AwaysHealthcare in Transition & the Move Online ImplicationsPHRs Today Adoption/DriversChallengesSuccessesPHRs Tomorrow PlatformsMHealthDeath of PHRs Slide 3 Macro Trends Reshaping HealthcareGrowing Consumerism in Healthcare Employee Accountability & Cost Sharing Out of Pocket Expense Yr'00: $200B, Yr'07: $267BDisintermediation of Care Retail Clinics, eVisits, MedTourism, Virtual LabsInformation Liberation Traditional: PubMed, Mayo, WebMDCrowd-sourced: Wiki(s), Blogs, Twitter,CommunitiesStimulus Bill & Healthcare Reform Unprecedented $$$ to Digitize HealthcareComparative Effectiveness Slide 4 While Consumers Increasingly Go Online for Health Info. MaleFemale60+67%71%40-5978%83%18-3980%85%Source: Pew Research 200674% of all adults are onlineNow One of the Top Activities on the Net Slide 5 Few Manage Health Records on NetYes 30%No 56%Don't Know 14%Paper 76%Web-based 11%Basic Desktop App 10%Specific App 4%Source: Forrester Research Q2'08 Survey.n= 5,242Today, Meager 3.3% iManage PHI Slide 6 Three Dominate PHR ModelsDirect to Consumer => Manage Records Consumer has Full Control Consumer self-populates, disconnectSmall ISVs with Little Market Influence CapMed, Medikeeper, PassportMDPayer/Employer Sponsored => Lower MLRs Consumer has Limited Control Trust issues, portabilityFocus on HRAs, Health & Wellness, Disease Mgmt Incentives common to drive adoptionProvider Sponsored => Customer Retention Consumer has Limited Control Little portability, modest tools, incomplete longitudinal recordPresent Labs, Meds, Discharge Facilitate transactional processes Slide 7 PHR Adoption is Widely DispersedEntityTypeNo. of UsersPHR PlatformFeaturesKaiser-PermanenteProvider3.0M+MyChartEMR portal w/email & transaction servicesPortability w/HealthVaultVeteran's AdminProvider650KRYO (VistA)EMR portal, Not portableWebMDISV500KWebMDClient defined, claims-based HRA & alerts Rarely portableAetnaPayer~780KActiveHealthFocus on HRA, DM, aggressive build-out Portability w/HealthVaultUnited Health GrpPayer~200KHealthAtoZClaims-based, part of new OptumHealth Div. Portability w/HealthVaultCleveland ClinicProvider100KMyChartSimilar to KPPortability w/GoogleBIDMCProvider40KRYOAging portal w/emailPortability w/Google & HealthVaultAll OthersMix2.5MCountlessHighly variable, most simple templates Little portability Slide 8 PHRs: What Are They Good For?EMC Adoption: Over 50% of EmployeesBenefit: Lower MLRs = Lower Healthcare Costs NET: $50M in 4 yearsKaiser-Permanente Adoption: Over 50% of Members with Internet AccessBenefit: Cost Savings via Fewer Office VisitsIndiana University Adoption: Over 40% of Entering ClassBenefit: Lower Admin Costs, Student EngagementAll Depends on Who You Ask! Slide 9 Top 3 Challenges to AdoptionData Getting it, Cleansing it,Sharing itTrust Privacy & SecurityProvidenceValue PersonalActionableRelevantConsumer Engagement Begins Here Slide 10 "Health Clouds" on the HorizonAttributesPotentialNotesData Source(s)HighVirtually any pertinent data sourceControlHighStrong consumer control of dataInteroperabilityHighAdoption of Open Systems and standardsPortabilityMediumStill under developmentToolsVery GoodMultiple tools/widgets, communications???PersonalizationHighFarther down the roadAdoptionHighPerceived value? Slide 11 Health is Mobile!Explosive Growth in Use Over 1B AppStore DownloadsIPhone Rep. 0.7% of All Internet TrafficOver 30K Apps Nearly 1.5K are Health FocusedEvery Major Mobile OS Now has App MarketAnd Still Only mHealth1.0 Slide 12 Evolution Accelerates PHR AdoptionA graph showing 4 stages to the PHR Adoption is shown.Gen 1: IsolatedGen 2: Online & ConnectedGen 3: Data Aggregation. (Health Clouds Form)Gen 4: Personal, Actionable & Mobile Slide 13 Generation 4: "Convergence" Personal, Actionable, ConnectedValue: About Me, By Me, With Me, For Me Slide 14 What to WatchTraction of Platform Plays Data Sources (agreements) E.g., Cleveland-Google, KP-MSNew HIPAA ExtensionsConsumer Adoption Sub-group typesDeveloper Adoption Popular apps/servicesEmployer Successes Demonstrable ROIAll Things mHealth Smartphones change equation Biometrics play key role Slide 15 Looking Into the Future.Biometric Devices Become a Critical Data SourceHIEs will Serve Citizens as WellData Liquidity & Quality willProve ChallengingMeaningful Use Requirement May BackfireBiggest Challenge: Sourcing Quality Data Slide 16 Final Thoughts.Time to Ditch PHR Term Consumers NOT Interested inDigital File CabinetPersonal Health Platforms(PHP) are Future Personal, Actionable DataEducation Critical What's in it for me?Without Consumer Engagement,HIT Adoption may be DOA Stimulus Funding is Not Enough to Move Needle Slide 17 The First Wealth is Health -Ralph Waldo EmersonThe Best Way to Predict the Future is to Create itPeter Drucker Current as of December 2009 Internet Citation: PHRs: Where We've Been, Where We're Going (Text Version). December 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/conference/2009/moore/index.html
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