The insurers initiative would cover more patients earlier, becoming available to 100 million patients by March 2007, according to an announcement from Americas Health Insurance Plans and the Blue Cross and Blue Shield Association. In contrast, the employers initiative is slated to roll out in the middle of 2007 and to start with far fewer patients.
The insurers estimate that they already provide PHRs for 70 million patients, but these do not allow patients to transfer information when they change insurers. The new PHRs will.
BCBSA and AHIP officials say they have already pilot-tested standards that will allow a patients information to move with a patient who changes health plans, assuming the patient authorizes the transfer.
Information stored in PHRs include patient histories, medications, immunizations, allergies, risks and plans of care. Patients information from one insurers PHR will only be transferred to a new PHR after they enroll in a new plan.
The announcement from the BCBSA and AHIP included a quote from the reigning health IT czar, Robert Kolodner, praising the insurers efforts.
Insurers say that PHRs will reduce the incidence and cost of medical errors, unnecessary tests, and patients tendency not to take prescribed medicines.
"PHRs may be one of our most important contributions to helping improve health care in the U.S.," said Aetnas Ronald A. Williams, CEO of the Hartford, Conn., insurance provider.
The employers scheme, called Dossia, is to be administered by the non-profit Omnimedix Institute.
The information contained would not be accessible to employers or insurers. Patients would also be able to designate what parts of their health records could be seen by which health care providers.
Dossia also plans to collect information from the clearing house where providers file claims rather than from insurers directly. Eventually, it will collect data from other sources as well.
Karen Ignagni, president and CEO of the Washington-based AHIP, said that insurers, which collect medical information when they process health claims, were uniquely able to contribute to widespread PHRs. "Until now, the information contained in PHRs has not been consistent—a concern that led several physician organizations to urge the industry to identify the core data for PHR content—or portable from health plan to health plan," she said.
The next step is to build applications on top of the PHR to encourage healthy behaviors, from reminders for immunizations to reward programs for exercising.
However, many physicians say they feel that claims data is inferior to the more-detailed clinical data that they collect in their own paper or electronic records. Some say that claims data becomes distorted because doctors fill out claims information to help reimbursement go through quickly, rather than to reflect nuances in a patients condition.
"One of the way businesses keep us locked in is by locking in our data. So its extremely courageous for them to do this," said J.D. Kleinke, head of Omnimedix, the Portland, Ore., group that is in charge of the employer-sponsored PHR effort praised the move by insurers.
But, Kleinke said, patients distrust of insurance companies would probably keep them from wanting to amalgamate their health information.