December 6, 2006 4:48 PM PST
Medical records mashup would span a lifetime
Applied Materials, BP America, Intel, Pitney Bowes and Wal-Mart Stores have sunk an undisclosed amount of money into the Omnimedix Institute, a nonprofit organization that developed and will manage the database, called "Dossia."
Dossia, which in 2007 will be made available to the companies' 2.5 million U.S. employees, dependents and retirees, will hold medical records from multiple sources for a person over their entire lifetime. The database could include test results and medical evaluations from various doctors' offices, hospitals and pharmacies.
The impetus behind the initiative is to curb health care costs by cutting down on administrative costs; reduce medical errors and costs associated with duplicate tests when it comes to health care services; and offer convenience to people wanting access to their own records, the companies said.
Project administrators and promoters anticipate the usual challenges associated with the move to medical technology. One is a fear of private medical information being exposed to employers, advertisers and others. Another is a resistance from insurance and health care managers who want to retain control over the current system.
"On the employee side, the biggest problem is people's complete mistrust," said J.D. Kleinke, CEO and chairman of the Omnimedix Institute. "People in (the U.S.) health care system have heard stories of people who have been burned, denied jobs or coverage for their health care data."
But Kleinke said Dossia will win trust because it's in the hands of an independent nonprofit organization and not an employer or health care manager. Colin Evans, the director of policy and standards for Intel's digital health group, shared that same sentiment.
"We're building it that way, based on principles agreed on and established. Groups like Connecting For Health came up with an architecture for a record locator system, which we're following pretty much to the letter," said Evans.
Evans also said that Intel would be willing to let leading health organizations come in and inspect Dossia.
"Any system to be secure has to be inspectable. I would suspect that we would allow the appropriate set of experts, the normal advocates, or in some cases nonadvocates, to take a look and make sure that it passes muster," he said.
Intel, one of the companies that initiated the project, spends more than $500 million a year on health care costs for its U.S. employees, Evans said. Estimates from Mercer Consulting show that a mature Dossia-like system with all employees participating could result in as much as a 7.1 percent savings in direct health care costs and employee-related productivity costs due to illness or time spent dealing with health care administration.
While there may be initial skepticism, Evans predicts that a new enthusiasm and interest in health will carry over into managing one's health records.
"Intel has wellness programs to encourage employees to take steps toward their own health," he said. "The take up is accelerating among our employees. I think there is a wave that is here to be surfed."
Evans also said that high-tech convenience could eventually influence the medical services market.
"Right now, maybe I can't change doctors because it's a huge fuss," he said. "If I can show up with data that has the most recent history in a format that the doctor can drop straight in his file...that creates an economic effect of competition and striving for service and investment on the part of providers."
As complicated as the architecture for this type of system is, Kleinke said the bigger challenges are rooted in the bureaucratic and political complexities of the health care system.
"In reality, a lot of health care organizations have every incentive not to share," he said. "They want lock-in. They want switching costs. They don't want employees to be able to switch plans."