Coalition Including Intel And Wal-Mart Plan Electronic Medical Records For EmployeesCoalition Including Intel And Wal-Mart Plan Electronic Medical Records For Employees

Why are businesses so keen to give employees access to their medical data? In part, it's setting the stage to hand workers more responsibility for the cost and management of their health care. It's called "consumer-directed health care" and often translates to higher deductibles and copayments and other conditions that motivate employees to consider costs when buying health care. "All this stuff about personal health records is in part window dressing for consumer-directed health care," says Gartner research VP Wes Rishel. Since Dell began offering personal health records alongside other health improvement plans two years ago, participant health care costs have dropped 10%, the company says.

The coalition is unusual, though Wal-Mart's Dillman signaled last year that she thought there was potential for IT-led efforts to cut health care costs. Speaking at information's Fall Conference, she said she planned to take up with Wal-Mart's CIO Summit--a group of tech chiefs from top suppliers--whether there was more they should be doing to lower costs. Soon after, she was promoted to her new role, with responsibility for Wal-Mart's health care and benefits as well as environmental issues.

Not everyone's convinced a coalition for personal health records is the right route. Cisco Systems was approached by Intel but declined. Dr. Jeff Rideout, Cisco's VP of health care, says the return may not be there for Cisco's relatively young and healthy employee base. "The people most likely to use the personal health record are those with a chronic condition, so you've got to know your audience," he says. Gartner's Rishel notes that wellness programs and physician quality programs also can help companies promote a healthier workforce.

The technology still needs to mature as well. Though systems and standards are emerging to feed information from physician records, lab results, and insurance claims into a centralized database, some early systems rely heavily on patient-entered data. "It's like asking someone to do online banking, but they have to enter their entire statement every time it gets mailed to them," says Ken Tarkoff, general manager for consumer solutions for McKesson. "The market is still a long way away from a true standard for communicating back and forth."

It's also uncertain how doctors might use personal health records in a system like the one Intel and Wal-Mart envision. Patients will be able to give doctors full or selective access to the records. But doctors will likely rely on their own systems, many of which can't be viewed by patients.

For electronic health records to become ubiquitous, there must be standards so that employees switching companies can roll over their records in a manner similar to 401(k) plans. The federal government's Health Information Technology Standards Panel is charged with picking among different standards for the systems that the health care industry adopts, and many companies are contributing to their development.

Data privacy and security are another obstacle. "People are automatically sensitized to the fact that health information is every bit as important as financial information and needs to be protected," says Michael Taylor, an analyst at Towers Perrin. IBM's Grundy says one company involved in the coalition project approached him last week with questions about privacy.

The bottom line is that patients, if they're going to take more control of their health care, need more information. Digital records are the only practical answer, whether they're managed by health care providers, insurers, employers, or some combination.

Employers are likely to provide incentives--carrots and sticks--to get their people on board. Dell, for example, gives employees credit on health care premiums for using online tools. WebMD CEO Wayne Gattinella says incentives drive greater than 90% participation.

The government, too, is pushing to make more data available. President Bush recently signed an executive order forcing health care providers to be more transparent in terms of costs and information on quality of care. On all fronts, businesses that pay for health care aren't willing to wait for the industry to heal itself.