Wal-Mart Rolls Out E-Health Records To All EmployeesWal-Mart Rolls Out E-Health Records To All Employees

Wal-Mart is rolling out electronic personal health records to 1.4 million employees plus their dependents as part of the company's benefits open enrollment season this fall.

The discount retailer is the first member of the Dossia employer coalition -- which suffered some legal and development setbacks last year -- to offer the consortium's personal health record (PHR) system in volume to employees.

Dossia members began piloting the e-health records with small groups of employees earlier this year. Besides Wal-Mart, Dossia consortium members include Applied Materials, AT&T, British Petroleum, Cardinal Health, Intel, Pitney Bowes, and Sanofi-Aventis.

Nonprofit organization Dossia was launched in December 2006 by Wal-Mart, Intel, and the other large employers for the creation of a secure, Web-based infrastructure to provide patient-controlled, electronic PHRs to more than 2.5 million workers, retirees, and their dependents.

Colin Evans, CEO and president of Dossia, who's also director of policy and standards for Intel's health group but is "on loan" from Intel full-time to the consortium, said that while Wal-Mart is the first Dossia player to roll out the PHRs to employees, other coalition members will begin offering them next year. "The pipeline is mapped out for '09; we've got a dance card," he said.

Wal-Mart is offering the e-PHRs as a voluntary benefit that employees can sign up for during the fall open enrollment process, with access to the PHRs beginning in January, said Sarah Clark, Wal-Mart's VP of benefits. So far the response from Wal-Mart employees -- who were first told about the upcoming PHR offering earlier this year -- has been "very good," said Clark. "We'd love to have everyone have a personal health record," she said, declining to disclose what Wal-Mart's actual internal goal is for employee sign-up. "Our goal is to provide our associates with resources they need to make better health decisions," she said in an interview with information.

"The records are personal, private, and portable," said Clark, explaining that neither Wal-Mart nor other third parties have access to the PHR data, and that workers can still access the information if they leave Wal-Mart's employment.

Clark acknowledged that workers at companies like Wal-Mart have an increasing number of options in creating e-PHRs as companies like Google, Microsoft, Revolution Health, and others roll out PHR offerings to consumers. In the bigger picture, Clark said it really doesn't matter whether some Wal-Mart employees choose to use one of those other options, like Google or Microsoft PHRs, instead of Dossia's. What is key, she said, is that workers keep track of their health information to help them make better health decisions.

The philosophy behind the Dossia companies offering e-health records to their workers is this: Providing individuals access to their own health data -- which is generally scattered thoughout the nation's health system -- will encourage employees and their families to be more proactive in their care, helping them make better health care and wellness decisions, live healthier lives, and, among other things, avoid expensive complications associated with chronic diseases. The hope of Dossia members is to ultimately curb soaring health care benefit costs by empowering their workers with access to their own health data.

Initially, Dossia aimed to begin providing employees with PHRs in 2007. However, work on the project hit roadblocks several months into the effort when a legal brawl broke out after the original prime contractor of the system, nonprofit Omnimedix Institute, allegedly missed development milestones and Dossia allegedly withheld scheduled payments.

The dispute between Dossia and Omnimedix was later moved from the courts and into private arbitration. Dossia in September 2007 then forged a fresh development partnership with Children's Hospital Boston. The underlying capabilities of the Dossia PHR system is based on Indivio, an open source, scalable platform Children's Hospital built for its patients in 1998.

Except for Wal-Mart, most other coalition members are planning to wait till after their 2008 open enrollment season to offer the PHRs to employees because workers already have an avalanche of information to sort through as they're making their benefit choices for next year, Evans said in an interview with information.

Dossia has been building its architecture in three layers, said Evans. That includes exporting into Dossia's repository patient data from health plans and pharmacies that work with Dossia member companies like Wal-Mart.

Eventually, the Dossia repository will also include data from other health institutions, like health care providers and labs, he said.

The second layer involves Dossia storing and securing that information, which is "patient-controlled." That means employees decide who can look at their PHR data, and whether to share it.

The third layer involves applications that "sit" on top of Dossia. In Wal-Mart's case, that includes WebMD personal health applications. Wal-Mart employees will access their Dossia-powered PHRs through personal health accounts offered by WebMD.

"That's the first of many tools," that will be coming from third-party companies like WebMD, he said. "Over time, we will have other data feeds, more applications sitting on Dossia," he said.

In addition to Dossia's current members, other employers have expressed interest in providing its workers with Dossia PHRs, Evans said. "It's clearly our goal" to attract other members to the consortium. "We've maintained dealings with many companies that prefer to let the founding members do the heavy lifting" during the development and initial rollout of the Dossia PHRs, Evans said.

Dossia does not have plans to enter any partnerships with Google or Microsoft in their consumer-oriented PHR efforts, said Evans. "Dossia is a nonprofit," he said. "I'm paid to house the data for associates, not make money," he said. Clumping the PHR strategies of Google, Microsoft, and Dossia together under one umbrella is "like saying that soccer and football are the same because guys are chasing a ball around," he said.

The majority of Dossia's development staff is based in Cambridge, Mass., where Dossia's "technology hub" is not far from Children's Hospital Boston. There's also a small Dossia team in Portland, Ore.