Close Close

Life Health > Health Insurance > Health Insurance

PPACA and Personal Health Records

Your article was successfully shared with the contacts you provided.

One of the fundamental pillars of the new Patient Protection and Affordable Care Act (PPACA) — the health reform act — is the expansion of electronic health records (EHR).

The act went so far as to partially subsidize the cost of conversion of paper records into electronic form. This has fueled something of an explosion in companies developing and providing online personal health records (PHR) services and systems to patients and doctors alike.

The advantages of PHRs, as a general concept, are clear.

First, the technology encourages patients to become actively involved in their own health care and to also become more aware of their medical conditions, medications, allergies, recent testing and overall health history. There’s also the potential for a significant increase in patient safety, especially in emergency cases when critical information is needed immediately in an accurate, complete and easily accessible format.

Health care cost reduction is another potential benefit from PHRs and in an era of finite health care resources, aging population and increasing health care costs, this issue takes center stage. Savings can come from the decrease in testing and procedure redundancy, which carries a significant risk to patient’s safety as well. PHRs can make the sharing of medical information among providers seamless, helping further reduce errors. The fact many PHR providers give patients access to their data via Internet-connected electronic devices make PHRs a powerful concept whose true full benefit to patients and impact on health care costs can only be realized with time.

PHRs and EMRs are also likely to serve the insurance industry by making it easier to detect redundancy in testing and procedures. This will advance health care cost containment, increase safety to patients and create a trickledown effect that can decrease insurance premiums. This result will no doubt benefit insurers in terms of lives covered, appeal and market share.

All these potential benefits highlight the critical importance of choosing the right PHR for the job, one that will provide easy access for patients and providers alike, is intuitive, user friendly, comprehensive and would provide the entire spectrum of services needed.

Why aren’t more regular people using PHR systems?

The current PHRs are far from perfect.

For example, there is a significant lack of completeness and uniformity among the various systems and vendors. While one PHR provider might provide patients with the ability to personally enter their own basic medical information and create their own PHR, it might not provide them with the ability to access essential medical information from their various physicians’ offices or from different hospitals.

PHRs currently range from very basic services that allow only limited information, input by the patients themselves, to very advanced services that act as health information custodians. The latter type of PHR service takes charge of collecting, digitizing, archiving and organizing a patient’s entire medical history from personal information and demographics to inpatient records, outpatient records and holistic medicine records. Currently, there are only a handful of such advanced services that provide true and complete PHRs, providing patients and their physicians alike with the entire spectrum of medical information.

Another challenge is the inability of the various PHRs and electronic medical records (EMR) to communicate with one another.

This is due to the lack of technical standardization, which is a significant weakness. Without this essential process, the act of organizing and assembling a patient’s entire set of health records from various doctors’ offices and hospitals becomes onerous if not impossible. Navigating this process is challenging, even for the health care providers who are familiar with the intricacies of the various systems and is frustrating for patients. Recently however, significant strides have been made in terms of standardizing the technology used for storing and transmitting medical information. This should go a long way toward making this process seamless.

Additionally, now that PPACA has been vOalidated by the Supreme Court, we can look forward to a partial subsidy of the transition to electronic health records, paving the way forward for future programs that increases reimbursement to providers and hospitals who comply with the guidelines. When hospitals are incentivized in that regard, they are likely to comply. Medicare reimbursement remains a very significant source of revenues collected by many if not most hospitals and it remains the largest single insurance provider in our country.

With these facts in mind, insurance carriers that either develop their own or provide a third party PHR are likely to reap the benefits of these federal mandates. It behooves patients to seek out comprehensive PHR services now, and it is up to the health care and insurance industries to provide affordable services and facilitate standardization, without waiting for federal mandates to take effect.


© 2023 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.