As I think about a consumer-focused health world where consumers are truly at the center of their health experience, I see a strong need for information to help them make decisions.
That infrastructure doesn't yet exist today, and the PHR as an aggregator of data, such as Microsoft's newly released HealthVault won't change that. You're not going to see a critical mass of people go through the trouble of assembling their medical records online, unless they think its going to do something for them. In that sense, it is somewhat comforting that the backers of HealthVault have deep pockets, as it will be a while before consumers move to this platform. What's missing? The killer app.
In the PC wars, IBM compatible PCs became a standard, not because DOS was better than Apple's operating system (it wasn't) but because Lotus 1-2-3's spreadsheet ran better than the VisiCalc spreadsheet on the Apple II-- propelling IBM sales in the crucial business sector.
Until that killer app rises, with incentives aligned with purchasing parties, we'll see adoption stay at the level of the current Electronic Medical Records systems-- nice, but not yet Crossing the Chasm over into the mainstream.
Fortunately, as mentioned by RWJF's Lygeia Ricciardi, the business models of software companies work well with the creation of a platform that creates common data and standards.
Data contained in repositories such as HealthVault’s can form the bases of powerful tools that help individuals make good choices about health behaviors.
over into the mainstream.The open platform is likely to create economic opportunities for developers of PHRs and related applications. According to Peter Neupert, Corporate VP of Microsoft’s Health Solutions Group, for every $1 Microsoft earns from its existing products, applications that build on them earn $7. It would be great for PHR developers if that ratio were to extend into the health sector, too.
So if the killer app is going to deliver most of the value, what will it be? If you believe in Clay Christenson's approach (Seeing What's Next: Using Theories of Innovation to Predict Industry Change), these will have to fulfill some existing need on behalf of the purchaser--to perform a job. What might these jobs be?
), these will have to fulfill some existing need on behalf of the purchaser--to perform a job. What might these jobs be?Here are some of my thoughts. Please chime in with yours.
- Dashboards highlighting important trends with submitted data, and giving understandable means of addressing them (and tracking progress)--likely to require at home collection tools
- Scores synthesizing the complex information into a simple, meaningful number (e.g., Real Age)
- Connecting people with volunteer mentors, just like them, to address new diseases or improve risk factors
- Reduction in out of pocket health costs through reduced insurance premium
- Educational media (incl. games) that help people understand what pieces they think are important
- Telehealth services allowing at-home delivery of desired care leveraging the record
2 comments:
Part of the PHR adoption issues for consumers is two-fold:
First consumers don't have a way of making their PHR data portable. In fact, a broader question might even be who owns the PHR data?
Secondly, the "killer app" would have to mean that all stakeholders in a consumer's continuum of health (eg, the health plan, the employer or sponsor of the benefit, the provider and all ancillary services have to be integrated in a way such that the data is both easy to get to, but understandable and useful in changing health behaviors.
Great comments.
A large part of making the data portable will be the creation of standard formats, similar to the OPX file allowing financial transactions. The really tough thing will be making the complex medical terminology move seamlessly across applications (data warehousing issues) that will need standards around data creation-- and thus may be limited at first to hard metrics like lab tests, measurements, and pharmaceutical scrips.
I'm not sure I agree with your second point in the consumer-centered world. Today, yes, and its the reason why there are lots of issues with "compliance"-- which is an institutional, rather than consumer perspective. If the consumer is making decisions, these tools just need to add incremental value to the consumer-- and the others will have to take that consumer's demands as the primary priority. This is a very different mindset from the paternalistic system we have today.
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