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Major U.S. Employers Announce Development of Health Records Framework

By Cheyenne Hopkins, CQ Staff

December 6, 2006 -- Five major U.S. employers announced at a news conference Wednesday a partnership to develop an electronic health records framework for employees.

Applied Materials, BP America Inc., the Intel Corporation, Pitney Bowes Inc., and Wal-Mart announced they are funding the development of "Dossia," a Web-based framework where employees can maintain their personal health records.

With Dossia, the system will allow employees to organize their health record by manually entering data and gathering health information from various sources, which would be stored in a secured database. When Dossia is complete, it will begin drawing information from all available electronic health care sources for patients who request it. Individual electronic records, however, will be accessible only by employees or by others to whom they have granted permission.

"Dossia will empower individuals to manage their own health care, improve communications with their doctors, and ensure more complete and accurate information for health care providers than the current fragmented, paper-based system," said J.D. Kleinke, chairman and chief executive officer of the Omnimedix Institute, the non-profit organization developing Dossia.

President Bush has said that he wants most Americans to have an electronic medical record within 10 years and that such records will reduce health care costs and improve patient care. To help encourage hospitals, physicians, and other health care providers to invest in electronic health record systems, the Department of Health and Human Services announced in July a list of ambulatory, or outpatient, electronic health record systems approved by a federal panel.

On Aug. 22, President Bush issued an executive order requiring that providers and plans doing business with federal health programs meet "interoperability standards" when they acquire health information technology systems to ensure that those systems work well with each other.

Dossia is based on the Connecting Health Common Framework, a set of standards established by a public–private collaborative group whose goal is to advance health information technology.

According to the companies, records stored on Dossia will be portable, able to be distributed by a print out, transferable electronic method, or portable device. The records also will be transferable when employees change employers, health plans, or doctors.

Doug Henley, executive vice president of the American Association of Family Physicians, said having such a standardized portable record is beneficial for both the patient and physicians.

The database will be rolled out initially in mid-2007 to U.S. employees of the five founding companies, which represent 2.5 million employees, family members, and retirees. After the preliminary stage, it will be available to other health application developers and possibly later additional employers.

Kleinke said many have looked to the federal government to build a "highway" for electronic medical records, but a better way to build health IT is through consumers. This year Congress did not agree on legislation (S 1418, HR 4157) that would have promoted improvements in health IT.

"No, we're not counting on Congress," Kleinke said.

Craig Barrett, chairman of the Intel Corporation, said employers pay half of health care costs but they have so far been absent from the discussion. The five founding companies have invested at least $1 million in Dossia, and employers will pay a "nominal" sum in the long term, Barrett said. Kleinke added that once the infrastructure is built, the cost of maintenance will be small.

Government officials praised the move by the companies.

"The leadership of these companies in offering personal health records is encouraging, and I hope more employers will make similar commitments soon," HHS Secretary Michael O. Leavitt said in a statement Wednesday. "We know that the use of health IT based on recognized standards leads to better health care for patients at lower cost and with less hassle."

Centers for Disease Control and Prevention Director Julie Gerberding said Dossia also will be an important tool for disease and epidemic prevention.

However, some consumer advocates have raised privacy concerns with the use of electronic records.

Kleinke said provisions are in place in the system to address privacy, including an authentification system and adoption of electronic standards required by the Health Insurance Portability and Accountability Act, known as HIPAA. The 1996 law (PL 104-191) protects the use and disclosure of individually identifiable health information. Individuals opt-in to the Dossia system and then decide whom to share their entire or portion of their record. The data also will be organized on a fragmented system to prevent any security breach from having access to the whole record.

Linda Golodner, president and chief executive officer of the National Consumers League, said consumers need more control of their health privacy.

"I hope other employers have the same principles in mind—that it's hands off and it has to be in control of the consumers," Golodner said.

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