PHRs: Where We've Been, Where We're Going (Text Version)

On September 14, 2009, John Moore made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (6.5 MB).

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Slide 1

PHRs: Where We've Been, Where We're Going

Where We've Been, Where We're Going

By: John Moore, Managing Partner
John@ChilmarkResearch.com

 

Slide 2

Three Take-Aways

• Healthcare in Transition & the Move Online
  • Implications
• PHRs Today
  • Adoption/Drivers
  • Challenges
  • Successes
• PHRs Tomorrow
  • Platforms
  • MHealth
  • Death of PHRs

 

Slide 3

Macro Trends Reshaping Healthcare

• Growing Consumerism in Healthcare
  • Employee Accountability & Cost Sharing
    • Out of Pocket Expense Yr'00: $200B, Yr'07: $267B
  • Disintermediation of Care
    • Retail Clinics, eVisits, MedTourism, Virtual Labs
• Information Liberation
  • Traditional: PubMed, Mayo, WebMD
  • Crowd-sourced: Wiki(s), Blogs, Twitter,
    Communities
• Stimulus Bill & Healthcare Reform
  • Unprecedented $$$ to Digitize Healthcare
  • Comparative Effectiveness

 

Slide 4

While Consumers Increasingly Go Online for Health Info.

	Male	Female
60+	67%	71%
40-59	78%	83%
18-39	80%	85%

Source: Pew Research 2006
74% of all adults are online

Now One of the Top Activities on the Net
 

 

Slide 5

Few Manage Health Records on Net

• Yes 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= 5,242
Today, Meager 3.3% iManage PHI

 

Slide 6

Three Dominate PHR Models

• Direct to Consumer => Manage Records
  • Consumer has Full Control
    • Consumer self-populates, disconnect
  • Small ISVs with Little Market Influence
    • CapMed, Medikeeper, PassportMD
• Payer/Employer Sponsored => Lower MLRs
  • Consumer has Limited Control
    • Trust issues, portability
  • Focus on HRAs, Health & Wellness, Disease Mgmt
    • Incentives common to drive adoption
• Provider Sponsored => Customer Retention
  • Consumer has Limited Control
    • Little portability, modest tools, incomplete longitudinal record
  • Present Labs, Meds, Discharge
    • Facilitate transactional processes

 

Slide 7

PHR Adoption is Widely Dispersed

Entity	Type	No. of Users	PHR Platform	Features
Kaiser-Permanente	Provider	3.0M+	MyChart	EMR portal w/email & transaction services Portability w/HealthVault
Veteran's Admin	Provider	650K	RYO (VistA)	EMR portal, Not portable
WebMD	ISV	500K	WebMD	Client defined, claims-based HRA & alerts Rarely portable
Aetna	Payer	~780K	ActiveHealth	Focus on HRA, DM, aggressive build-out Portability w/HealthVault
United Health Grp	Payer	~200K	HealthAtoZ	Claims-based, part of new OptumHealth Div.  Portability w/HealthVault
Cleveland Clinic	Provider	100K	MyChart	Similar to KP Portability w/Google
BIDMC	Provider	40K	RYO	Aging portal w/email Portability w/Google & HealthVault
All Others	Mix	2.5M	Countless	Highly variable, most simple templates Little portability

 

Slide 8

PHRs: What Are They Good For?

• EMC
  • Adoption: Over 50% of Employees
  • Benefit: Lower MLRs = Lower Healthcare Costs
    • NET: $50M in 4 years
• Kaiser-Permanente
  • Adoption: Over 50% of Members with Internet Access
  • Benefit: Cost Savings via Fewer Office Visits
• Indiana University
  • Adoption: Over 40% of Entering Class
  • Benefit: Lower Admin Costs, Student Engagement

All Depends on Who You Ask!

 

Slide 9

Top 3 Challenges to Adoption

• Data
  • Getting it, Cleansing it,
    Sharing it
• Trust
  • Privacy & Security
  • Providence
• Value
  • Personal
  • Actionable
  • Relevant

Consumer Engagement Begins Here

 

Slide 10

"Health Clouds" on the Horizon

Attributes	Potential	Notes
Data Source(s)	High	Virtually any pertinent data source
Control	High	Strong consumer control of data
Interoperability	High	Adoption of Open Systems and standards
Portability	Medium	Still under development
Tools	Very Good	Multiple tools/widgets, communications???
Personalization	High	Farther down the road
Adoption	High	Perceived value?

 

Slide 11

Health is Mobile!

• Explosive Growth in Use
  • Over 1B AppStore Downloads
  • IPhone Rep. 0.7% of All Internet Traffic
• Over 30K Apps
  • Nearly 1.5K are Health Focused
• Every Major Mobile OS Now has App Market
• And Still Only mHealth1.0

 

Slide 12

Evolution Accelerates PHR Adoption

A graph showing 4 stages to the PHR Adoption is shown.

• Gen 1: Isolated
• Gen 2: Online & Connected
• Gen 3: Data Aggregation. (Health Clouds Form)
• Gen 4: Personal, Actionable & Mobile

 

Slide 13

Generation 4: "Convergence" Personal, Actionable, Connected

Value: About Me, By Me, With Me, For Me

 

Slide 14

What to Watch

• Traction of Platform Plays
  • Data Sources (agreements)
    • E.g., Cleveland-Google, KP-MS
    • New HIPAA Extensions
  • Consumer Adoption
    • Sub-group types
  • Developer Adoption
    • Popular apps/services
• Employer Successes
  • Demonstrable ROI
• All Things mHealth
  • Smartphones change equation
    • Biometrics play key role

 

Slide 15

Looking Into the Future.

• Biometric Devices Become a Critical Data Source
• HIEs will Serve Citizens as Well
• Data Liquidity & Quality will
  Prove Challenging
• Meaningful Use Requirement May Backfire

Biggest Challenge: Sourcing Quality Data

 

Slide 16

Final Thoughts.

• Time to Ditch PHR Term
  • Consumers NOT Interested in
    Digital File Cabinet
• Personal Health Platforms
  (PHP) are Future
  • Personal, Actionable Data
• Education 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 Emerson

The Best Way to Predict the Future is to Create it
Peter Drucker