John Moore from Chilmark Research compared several business models for PHI delivery. These include: 1) Consumer approach to manage health, 2) Employer and healthplan approach to reduce costs and manage risks, 3) Provider approach for consumer (patient) retention, and 4) Utility service model approach to "create an ecosystem".
The utility service model consolidates multiple data sources into a secure repository available to multiple applications and services. This model scores very well, with the notable exception of portability which is "under development". Moore scored the utility service model as the only approach with the potential for high rates of adoption.
Markle contends that the establishment of privacy and information practices are critical to consumer PHR adoption.
Markle's Connecting for Health Common Framework and Framework for Networked Personal Health Information define clear "price of admission" requirements for PHR adoption, but are they sufficient to achieve adoption?
Standards and Interoperability Connectivity with healthcare organizations will be required to make PHR's easy to access and manage. Jeff Blair, Lovelace Clinic, made the case for the Nationwide Health Information Network and standards based interoperability as foundational elements to achieve adoption.
Editorial comment: Where are the incentives? The one missing ingredient in all of this: financial incentives for patients and providers. Why are payers and employers more interested in PHR adoption? They are dealing with the pocketbook issues of how population health affects their P&L.