Clinical laboratories have traditionally been the primary storehouse for laboratory test data. Not only has this been a strong source of added value to clinicians, but it positions clinical laboratories to be major players in the approaching age of genetic medicine. Now there’s a new threat on the horizon. Several of the nation’s largest corporations are preparing to handle the electronic health records (EHRs) of their employees.
The first news of this nascent trend was a story in The Wall Street Journal on November 29, 2006. The article stated that in the first week of December, Intel Corp, Wal-Mart Stores, Inc., British Petroleum America Inc., Applied Materials, and Pitney Bowes would disclose a plan to provide digital health records to their 2.5 million workers and their dependents.
The plan was announced and the group of employers was identified as the Dossia Founders Group. Collectively, this group is funding the Dossia Network, an independent secure, non-profit infrastructure for gathering and securely storing information for lifelong health records in a multimillion-dollar-data warehouse that will link hospitals, doctors, and pharmacies.
Why, you’re probably asking yourself, would big business want to get involved in the business of electronic health records? As with all things corporate, there is a monetary savings at the root of the corporate goodwill. The companies hope that cutting out the paperwork in health care would reduce administrative costs, duplicative care, and medical errors. In turn, the potential savings would make it easier for employers to continue sponsoring health care insurance for their workers.
Officials say that the Omnimedix Institute of Portland, Ore., will maintain the health records. Omnimedix will gather the information from insurers, pharmacies, doctors and other health care providers. Patients will be able to update the record with items such as their family’s history of illness.
The Dossia Network brings up two long-standing and unanswered questions. First, who owns a patient’s data? These big employers seem to suggest that it’s the patient that owns their own data. When given the opportunity to control their own EHR, many patients will likely opt out of the benefit because of concerns about privacy. Patients fear an EHR with their complete medical history might alert insurers to potential health problems and lead them to deny coverage or increase premiums.
The second question raised by the creation of the Dossia Network is this: Should the US allow corporations to set the standard for the EHR? The fragmented US health system has had little success developing a standard for EHRs, especially a standard that will cross between hospitals and state lines. Now several corporations, with a total of over 2.5 million employees, are preparing to launch their own version of an EHR – with little input from the US health system. Omnimedix is in a rare position of power, where it may be able to define the standard for the EHR that gains wider use in future years.
Lab directors and pathologists should take note of one specific goal of this corporate EHR project-Eliminating duplicate tests as one way to lower the overall cost of healthcare. One interesting consequence of employer-funded EHRs is that their use may provide credible measurements of the actual level of laboratory test over-utilization.
Laboratories wanting to stay abreast of this important trend in EHRs should become familiar with the EHR standard as it is created by Omnimedix and the Dossia Network. They can then prepare the necessary informatics interfaces to allow them to submit electronic results into the individual patient records of these EHR systems.