Great post!!

As an active member of the Health Record Bank Alliance (HRBA), an organization promoting the consumer as the true owner of their personal health information with complete access to and ultimate control over its disposition, it is refreshing to see this important shift in strategy. To borrow your highway analogy, spending billions of dollars to motivate provider adoption of EHRs is like putting a sleek car in the garage with no roads built to drive to the highway…..pretty to look at…..but not very useful if you can’t connect to anything “meaningful.”

To date, as everyone well knows, consumer engagement, while referenced frequently across most of the health information technology venues, is pure lip service, marginalized in the greater effort to implore healthcare stakeholders to play in the same sandbox together.

Adoption of the Health Record Bank model solves the problem of withholding data by competing interests. If the consumer asks for their data, by law, it must be released to them…..done deal!

I am sure that Bill Yasnoff, MD, Executive Director of the HRBA would be interested in sharing his views on this topic. I wanted to share the HRBA website with everyone and point to the HRBA Principles document linked on the home page:

http://www.healthbanking.org/index.html

There is a long way to go, but it’s a start……….we are “ALL IN.”

RFV

Most of the HIE’s around the country, don’t really know how to evolve their current technology. The technology to this point, should really be scrapped. Google, Microsoft, and Health Banks get what they need so why not leverage what is underway? Why do we have to take what NHIN created and salvage it? Let’s admit that the first 4 yrs were a trial and admit that it won’t work and learn from others what will work.

I really hope that our money will go into finding out the right balance for the consumer and how to engage people in their own healthcare. After all, we have to change the habits of individuals if we want to make a dent on our spending. While clinicians may not like the change they must also endure to improve quality and reduce cost, we do understand that clinician change is needed. With meaningful use incentives will be aligned.

Now if we can get incentives to be provided by insurance companies, employers, and the states to help individuals become engaged, we will make progress.

I think Chopra and Park have it right… a Fed centric network won’t work, won’t be robust enough and will never…ever reach the consumers. And there’s lots of legal hurdles that will have to be overcome.

I think they should scrap the most of the NHIN/CONNECT and work at the state and local levels to set up the backbone. The Feds already have a National Information Exchange Model (NIEM) that’s in use today across several large federal agencies. Why do they need a second one vis e’ vie, the NHIN?

You’re talking tens of years before we’ll have substantial EMR penetration and even longer for PHRs. It will take many more carrots and many more sticks to drive this.

Therefore, I believe we’ll see a clearinghouse/brokerage model for clinical information emerge even more strongly in the next 5 years.

That’ll be the avenue to get the consumer in the value chain faster.

How many understand that if there are not fundamental process changes in how the data originating from patients and the physicians they trust is created, all the fancy, top-down solutions promise to be little more than a lot of expensive technotitillation?

How many in the industry and government are still mostly focused on technotitillation rather than creating the the necessary bricks that are the foundation? Who has realized that physicians are not great brick-makers or data-entry clerks?

Who has a clue that absent the data from the patient-physician interface, none of the rest of it matters very much?

Great post.

You write: “But what might happen if the folks in DC stopped talking about the NHIN as some uber-Health Exchange, but instead positioned it as a consumer-focused platform?”

Do you really mean “instead”? or “in addition to”?

Are we just reconceptualizing NHIN as not only B2B, but B2C and C2C?

We are not going to have a “single enabling approach” anytime soon, interoperability will grow organically just as it has on the Internet. We need stakeholders to cooperate and innovate at the same time. The “Health Internet” is going to be a fluid, evolving, infrastructure for some time to come. This is as it should be!

Here at HealthVault we are marshalling our team to help make it happen — feels like it could be a real tipping point.

Our experience also shows that with the right targeting, PHRs are embraced and adopted. This year, 40% of the incoming freshman class at Indiana University’s main campus created an IU branded PHR prior to arriving on campus. Better yet, half of those students have used the PHR since school began to interact with the student health center. Last week, IU integrated its online appointment scheduling app with the PHR and registrations spiked again. Combine tech-savvy students who insist on conducting business online with helicopter parents who want to ensure the safety of their children, and you have a recipe for adoption and use.

Finally, having participated in the NHIN demo late last year, we have seen firsthand the power of connecting a PHR with the NHIN. It opened our eyes to the power of the Health Internet concept.