A survey of American consumers by Deloitte has found that 60% of respondents want increased online access to their healthcare providers, medical records and test results, but experts are not in agreement on how such access would affect health insurance premiums.

The “2008 Survey of Health Care Consumers”–a poll of more than 3,000 Americans between the ages of 18 and 75–also found that 1 in 4 consumers would pay more to physicians for such technology services, says Washington, D.C.-based Deloitte. In addition, 46% of respondents are interested in keeping an online or software-based computer health record.

“This would definitely make the value chain more efficient in health insurance,” states Matthew Josefowicz, director, insurance, at New York-based Novarica, an industry consulting firm. “Whether it would lower premiums is another question, since it wouldn’t necessarily address the cost of care. But it might improve margins.”

Asked if these new efficiencies in the value chain would enable insurers to save money by reducing or reassigning staff–which could mean savings for consumers–he concedes that “certainly, they should be able to become more efficient.

“But whether those savings outpace the growth in the cost of services, or whether they are passed on to the consumer is another question,” he adds.

According to Craig Weber, senior vice president at Celent, another consultant firm based in Boston, “I agree there are cost implications for insurers, and any movement towards electronic records will provide welcome relief in terms of costs.

“Customers should see some benefit if carriers are able to reduce costs,” he continues. “However, expense pressures on carriers have never been higher. Metaphorically speaking, carriers that find change under their couch cushions will be sorely tempted to put it in their pockets, rather than doling it back out to customers.”

Who’s in charge?

Bob Barry, senior vice president of product and market strategy for Connecture, based in Waukesha, Wis., calls giving consumers access to personal health records “an improvement in the healthcare industry.” Connecture focuses on delivering Web-based sales, service, and process automation solutions to the health insurance industry.

“In terms of affecting health insurance issuance, it depends on how often the record is updated,” he explains. “Who has the control; what goes into it and when?”

Barry points out that, “If the person has been diagnosed with a significant condition, but that information hasn’t been entered in the health record yet, and the consumer is shopping for a new health plan, then the carrier cannot solely rely on the health record for assessing the risk.

“I’m not sure that there will be tremendous cost savings,” he adds. He points to potential administrative cost savings in the underwriting process, “but really it would be another data access point, much like carriers that utilize pharmaceutical history in the underwriting process today, and I don’t know that the savings will be that significant.”

There may, however, be some savings because the consumer can access his or her own data, thus avoiding calling customer service, says Barry. “Any savings that do result are ultimately passed on to the consumer through reduced rates that are driven by the competitive landscape.”

Is it affordable?

According to Josefowicz, “The real challenge is that small independent doctors–the mass of the provider end of the industry–cannot afford to digitize existing records or to build the infrastructure to create new records electronically.

“This will take some outside funder–like the government or a consortium of carriers–to set up,” he adds.

Barry, however, asserts that providing electronic records for consumer access “shouldn’t be cost-prohibitive, especially if third parties like Google offer personal data records online. The ease of access and the centralization will make it attainable no matter the size of the practice.

“The key,” he continues, “will be the means of appending the data to the record. If electronic interfaces facilitate broad integration, then the costs will be kept in check.”

Indeed, says Weber, “The hard part in this industry is getting all the players to agree on a solution. But I think we’ve reached a tipping point, where there are plenty of benefits on all sides–everyone walks away with something.”

Is it secure?

Weber also cites another potential sticking point, wondering “whether enough insurers will latch on to the convenience [of electronic records] to offset the diehard privacy advocates who say that health information online is simply a bad idea.

“I would argue that electronic records–properly secured–are more secure than paper files floating around,” he says. “But selling that idea is difficult in light of disclosures about breaches of sensitive financial information.”

Securing data is in itself an expense, but according to Weber, these costs “pale in comparison to the inefficiency caused by ink on paper.”

“There are a lot of inexpensive ways to make data secure with password protection, data encryption, etc.,” states Barry. “Data security is not an enormous addition burden to be absorbed by the carrier. The carriers are used to it, and already have the knowledge and means to do it.”