Microsoft, WebMD and CIGNA on Consumer Medical Data

The title of this session is Next-Generation Consumer Engagement — New-Age Solutions to Advance Consumer-Driven Health.

Jim Mault, M.D., from Microsoft started with an illustration, asking how many people know how to access credit card transactions online vs. getting access to our immunizations or cholesterol test readings. Not surprisingly, only about half of the health geeks here knew how to get these health records. The absurdity defies explanation.

You’re already suffering the risk of someone (a hacker) getting your online health information, but getting none of the benefits.

Need Portability and Interoperability to realize the potential benefits. In HealthVault, Microsoft is developing a health info ecosystem, much like Facebook and MySpace did for digital photography. Unlimited opportunity for you to share your data, on your terms, with whomever you want.

John Young from CIGNA says lifestyle accounts for most of the risk of chronic conditions. He says it’s not a decision of whether to do consumer-driven health care, but how. By year end 59 percent of employers will be using consumer-driven models. Companies need to design their plans as an “on-ramp” to promote consumerism. He says consumerism could save about $2,300 per employee per year within 5 years, without cost shifts. CIGNA’s offering is CIGNA Care Connections, and he says the key is making it simple. Better choices = improved health and lower cost. Incentives drive better decisions. Pharmacy tools enable consumers to compare specific costs for their particular prescriptions. Next up is a Cost of Care Estimator. Patients will get much more interested in how much the bill will be when they have HSAs and similar plans. 

Need to change language; instead of “coinsurance” need to say “amount you pay after the deductible.” The goal is to build confidence and self-sufficiency among consumers.

Craig Froude from WebMD Health Services works with a lot of big employers and health plans with the goal of improving health outcomes and lowering health care costs. They create an individual profile for each IBM employee, for example, and import lots of data from various sources into the system without the employee needing to enter information. Based on these data he says they deliver personalized, targeted information and recommendations. It’s called WebMD Health & Benefits Manager. He says 1.8 million people took a risk assessment last year, and 43 percent started an exercise program, 40 percent changed diet, but 26 percent reported making no changes. His team’s goal is to increase the proportion of users actually taking action.

Vince Kuraitis, the moderator, concluded the presentations with what he calls “5 New Realities”

  1. Personal control of PHI displaces health care incumbents and puts patients in charge. Emerging reality: Patients say: “It’s my data. Hand it over. NOW.” Now HealthVault and Google are making it practical for patients to exercise the rights they already have.
  2. Proprietary IT and processes give way to open standards and collaborative business models. Collaborative Care Management Networks are required to coordinate care, just as you don’t worry today about using a non-network ATM (other than some extra fees.) But 70 percent of PHRs are not interoperable.
  3. The Personal Health Info Network facilitates incremental advances toward interoperability and liquidity. This has been moving very slowly, but now we’re moving from Ready, Aim, Fire to Ready, Fire, Aim
  4. The jury is in: patients will use PHRs. Conventional wisdom says adoption rates are low, but the emerging reality is patients value integrated PHR systems. Kaiser has 30 percent adoption and Group Health has 50 percent.
  5. Google, Microsoft and others are collaborating in creating a new ecosystem. Conventional wisdom says it’s a battle between the titans, but the emerging reality is “It’s a new ecosystem!”

In the ensuing discussion…

John Young says 5 percent of employees will be 50 percent of claims in any one year, but next year’s 5 percent may come from today’s health population. Thus the importance of health risk assessments. CIGNA requires HRA to be eligible for benefits.

Jim Mault says the reason people will use PHRs is because it makes life better for them in some way that’s important. Microsoft has been busy making the connections to various pharmacies, hospitals, etc., doing the groundwork so as users come online they will be surprised by the benefits and how easy it is. Competition between PHRs won’t be because they own your data, but because you can take your data wherever you want.

Craig Froude says 80 percent of IBM employees have an online PHR. John says we need to give incentives to take health risk assessments. Premium reductions for participations. Need to connect people to the realities they face. John has lost 65 pounds and has 25 to go because he was motivated by what he saw in his risk assessment.

Jim says HealthVault is open to any and all organizations, without exception, which should help make the portability/interoperability a reality. But the parties at the table (Microsoft, WebMD and CIGNA) aren’t connected yet. He says it’s just a matter of time until the consumer drives it to all open up.

Question from the audience (Kate from KP): With economy and job losses, aren’t people more concerned about keeping health coverage than they are about PHRs? Could health data in PHRs be used to discriminate?

This was an excellent panel. I hope what I’m able to contribute through my presentations will be at least somewhat as worthwhile as what I just heard.

Author: Lee Aase

Husband of one, father of six, grandfather of 15. Chancellor Emeritus, SMUG. Emeritus staff of Mayo Clinic. Founder of HELPcare and Administrator for HELPcare Clinic.

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