Here Is How PHRs Are Evolving It Would Seem - Not What We Are Planning with the PCEHR.

Dossia, who are one of the oldest PHR providers in the US are moving on in some very interesting ways.

First see here:

When Social Features Meet Personal Health Records

Employer consortium Dossia takes cues from social networking and games as it vies to boost usage of its personal health record site.

By Marianne Kolbasuk McGee, InformationWeek

July 20, 2011

URL: http://www.informationweek.com/news/healthcare/EMR/231002035

Employer consortium Dossia is adding new functionality to its personal e-health record system to improve engagement with users and help them better manage and improve their health.

The new Dossia Health Manager is an "intelligent" health management system that further extends Dossia's original e-personal health record capabilities beyond being a platform for individuals to store and track their health information to one that enables users' health data to become "actionable," said Dossia CEO Mike Critelli, in an interview with InformationWeek Healthcare.

The new system integrates game and social networking dynamics, incentives, and messaging in an effort to foster "sustained user engagement and behavior change," he said.

Dossia is increasingly migrating away from being "a pure health record system" to an intelligent platform with tools and applications to help employees better manage not only their health data, but their health, he said.

"We realized about 2-1/2 years ago that people want more than information, but tools to organize and act on the information," he said.

"We've been recognizing that self-insured companies have been asking for a return on investment" for the wellness and other programs they've been offering employees in hopes of reducing healthcare costs, he said. While employers often do a lot of discretionary spending on employee health risk assessments, wellness and prevention programs, and health coaching for employees, especially those with chronic illnesses, getting employees to regularly partake in healthy behavior promoted by these programs can be difficult. Also, employees often don't take advantage of these employer-sponsored programs.

The new platform can help nudge Dossia users to do so with reminders, and game-like activities to get them more engaged in tracking their health, whether it's a hypertension patient remembering to take daily blood pressure readings or a parent keeping on schedule with kids' immunizations, he said.

While employers do not have access to workers' Dossia health data, employers' health plans do process claims data that can indicate whether a patient is keeping up with refills for prescriptions to treat chronic conditions, and whether a patient is going to the doctor for recommended services. The Dossia platform can help employers and health plans devise benefit packages that incentivize healthy behavior, he said.

Based on information in an individual's Dossia health record data, the system can offer customized applications, such as tools and content geared to a person's chronic condition. For instance, if a patient is diagnosed as obese or pre-diabetic, the Dossia system may suggest recipes and health tips geared at helping the patient better control diet and weight as well as other factors that could help decrease the risk of actually developing diabetes or other medical complications.

Link to more is the text.

New Features for Dossia Employer-Sponsored PHR

Joseph Goedert

HDM Breaking News, July 20, 2011

Dossia, a Cambridge, Mass.-based personal health records vendor targeting large employers, has several new features in a next-generation version of the software.

The new version, called Dossia Health Manager, offers teleconsultation services with a physician within 30 minutes who can pull up a consumer's PHR and add to it during the consult. Employers will subsidize the service with varying consumer out-of-pocket costs depending on their benefit plan.

Much more here:

http://www.healthdatamanagement.com/news/dossia-phr-personal-health-records-42820-1.html

What we are seeing here are the Web 2.0 implementation of the PHR with clear health goals and outcomes defined and much more interactivity than even vaguely imagined with the PCEHR Concept of Operations.

All this just makes it clear just how unimaginative and flat-footed NEHTA has been in the design of the proposed PCEHR. Where exactly can one find the roadmap that explores the main ideas here (and yes I know they plan a patient note taking facility and adding a few more document types)?

If we are to have this monster thrust upon us then there seem to be some really interesting ideas which have simply not been considered. Pity that!

David.