Fingertip Health Care Histories

As a working mom with five kids ranging in age from 4 to 10, Barbara Kerecz needs all the help she can get to keep track of her family’s health needs.

She can’t afford to allow a child’s doctor’s appointment or a needed allergy prescription refill to get lost in the shuffle.

That’s why Kerecz set up an electronic personal health record for each of her five children with Aetna, the family’s health insurer. The service lets her use her personal computer to access and update their medical records, giving her greater insight into ways to improve their care.

“It’s become a one-stop shop for medical information,” said Kerecz, a 37-year-old from Tolland. “There is no hunting around for medical records anymore. I have all the information I need at my fingertips.”

Kerecz is one of thousands of Connecticut residents now logging in to personal health records, known as PHR’s. It allows her to keep a profile of her children’s health by storing information about doctor’s visits, medications and lab results, accessible via a password.

Several of the state’s top health insurers — Aetna, Cigna, Blue Cross and Blue Shield and others — are developing and marketing similar programs to compete in the digital world of health care, representing a shift in the insurance industry.

“It’s not just about paying claims anymore,” said Dan Greden, senior director of strategy and product management at Aetna. “Insurance companies are taking steps to give members resources to help them reach an optimal rate of health. We are becoming part of the health care process.”

And the company is spending big bucks on a multi-faceted advertising campaign to promote the service, featuring a model and the testimony, “My medical history is always working for me.”

Bill Field, president of Mintz and Hoke, a communications firm in Avon, said it’s a smart approach for insurers to market products that dovetail with growing consumer interest in actively participating in their own health care.

“When you know more, you’re better off — from both a health and cost perspective,” Field said.

Multiple Concerns

But critics warn of potential problems with the privacy, accuracy and usefulness of the records.

“In principle, it’s a good idea,” said Angelo Carrabba, a physician and president of the Connecticut State Medical Society. “People being involved in their own health care stimulates better awareness. But it should be looked at with a degree of doubting eyes from physicians.”

PHR programs allow for multiple sources of input. Aetna’s, for example, continuously stores and scans an individual’s health data and medical, pharmacy and lab claims. It then compares that information against several sources of medical literature and alerts consumers and doctors about possible urgent situations and opportunities to improve care.

Cigna’s PHR works in conjunction with WebMD. It is controlled by the insured consumer, who can input information on diet and exercise habits as well as family medical history. It also incorporates lab results.

Joe Mondy, a spokesman for Cigna, said PHRs are an obvious consumer option because insurance companies already compile claims data.

Physicians Skeptical

Health care experts applaud the concept but have expressed skepticism.

“It’s a buyer-beware market,” said Deborah Feel, a physician and founder of Texas-based Patient Privacy Rights, a nonprofit organization dedicated to ensuring that Americans control their health records. “You have to be very careful with who has your health data and what they use it for.”

Feel is also concerned that insurers might use PHR records against their customers. “The more an insurer knows about you, the more ammo they have to deny your claims or repeal your coverage,” she said.

In addition to those concerns, Feel also maintains that PHRs could be vulnerable to data mining, a process where companies sell customer information to advertisers.

But insurance company officials discounted that threat, saying they are regulated by HIPAA, the Health Insurance Portability and Accountability Act, which prohibits them from the unauthorized release of patient data.

“People have common fears about things being on the Internet,” said Greden of Aetna. “But we assure people that we have all the same technology in place that other financial institutions do to prevent [unauthorized data leaks].”

Mondy of Cigna added that technology firms offering non-insurance affiliated PHRs, such as Google and Microsoft, are more likely to participate in data mining deals because they aren’t subject to HIPAA.

Auditing PHRs

In an effort to improve privacy standards, several consumer groups, including Google, Microsoft and Aetna, recently agreed to external audits that will track how they use PHR data. They also agreed to establish a dispute resolution process for consumers who believe their personal information has been misused.

There is also a question of how useful PHRs will be. Physicians must have access to them if they are going have an impact, Carrabba said. “The potential [benefit] is definitely there if the health care provider can see them,” he said.

Most PHR programs require a customer’s consent before physicians can gain access, a possible problem in emergencies.

Kerecz said sharing her children’s PHRs with their physician is a must. “It really helps with the communication process,” she said. “Whenever my husband takes them to the doctor, they bring a printout of the personal health record. That way [the doctor] knows what has been going on since the last time he saw them.”

Accuracy is also a concern if consumers input sporadically or inaccurately. But insurers say most of the file is made up of claims data, not personal submissions.

In any case, Kerecz appreciates the convenience. “I’m no longer shuffling through tons of papers to find out information about my kids,” she said.