A couple of points of clarification. First, if you have read my posts here on the site, as well as the full report, you will see that I am cautiously bullish (yes, an oxymoron) on the potential for PHRs. I do believe that there are some very fundamental changes now taking place in healthcare sector (care fragmentation, plan redesign, larger co-pays, information access, etc.) that are creating a more vibrant market for PHRs, but the extent to which that market grows will still be contingent on a number of factors primary among them: EMR adoption, data liquidity (auto-populate PHRs), better PHR tools (value to end user) & consumer engagement.

Based on your comments, we agree on most of those points.

Where we differ is in your belief that only a tethered PHR (tethered to an EMR ala what Kaiser has done with MyChart) will succeed.

First, Kaiser is unique in that they are a fully capitated, vertically integrated provider/payer. Therefore, if a member has a care team for say a chronic disease, everyone is on-board. This is rare in the US with most chronic care consumers having a care team that is spread out, not necessarily in the same IDN, thus little sharing of records among themselves to facilitate care – that is left to the consumer to coordinate. In this scenario, a tethered PHR is of only modest value.

Second, there are PHRs now being sponsored by employers. This week, Wal-Mart announced that it will be offering employees a PHR (WebMD) that relies on the Dossia platform for data aggregation. Granted, only claims data today, but even claims data provides some utility to the consumer.

One of the early pioneering employers to offer their employees a PHR is the high-tech company, EMC. They were an early adopter and have worked hard to build out the PHR to serve its employees. Spoke to the lead person at EMC about 2 weeks ago and she stated that they now have 50% adoption (that is higher than Kaiser and on par with Group Health). Very impressive. Like most employer-sponsored PHRs, EMC’s relies heavily on claims data. With such high adoption, obviously there is perceived value in a claims-based PHR. But be assured, the EMC PHR has a lot more features than just viewing one’s EOBs!

Yes, the PHR market remains a niche market but from what I have seen in the rest of the healthcare sector, all HIT is one niche market or another.