Defining the ideal PHR, making the PHR work for members

Yesterday was the final day of the Kaiser Permanente HealthConnect Online Leadership discussion, which carried themes over from the previous day around making a Personal Health Record work for members. Of note:

  • Improving the ways members achieve secure access to the PHR. During the recent natural disasters in Southern California, Kaiser Permanente established a telephone-based process for members to verify their identity to use the PHR, for people who no longer had access to basic items like mailboxes and reliable computer access. This allowed them to continue to manage their health during difficult times. The system will eventually be expanded to include all members across the nation, with an online version that can provide secure identity verification.
  • Helping the industry to define the ideal PHR based on working models. Jan Oldenberg, from the Kaiser Permanente Internet Services Group, is bringing the experience of the organization to the public as it creates definitions and requirements for what a PHR should be. In this way, communities do not have to guess at the services and features that are most useful to patients as they ask for these services. Of note, Jan and the group are engaged in the HL7 PHR Standards Definition, which is currently accepting public comment until tomorrow. We (and all of you) are reminded to review these and provide input. When standards are agreed upon, we can all move forward quickly.
  • Customer Service Support. A PHR brings support needs with it, and Kaiser Permanente logs in the neighborhood of 40-50,000 calls a month, tied predictably to new feature rollouts, but also to issues that can be resolved by listening to members. I was personally delighted to hear that since Northern California began automatically sharing lab results in August, 2007, call volume for lab results has remained flat, despite larger volumes of information being shared with members. From my own work with PHR’s, I know that it is never too early to involve customer service support professionals in implementation. Going even further, it is never a bad time to sit with customer service professionals in person as they support members on the phone, in person. I’ve done this and it’s an incredible learning experience.

And the end of two days, I learned a lot, even as a pioneer in the PHR space myself. Here is an organization that is up and running in a big way, and they are beyond asking “should we do this?” They are saying, “We are doing this for our patients. Now, how do we do this better?”

There were no blanket statements, like, “we should do it this way.” Instead, I heard a lot of, “what do we know about what members need, and what works for them?” and “As a member, how would I feel about this or that approach?” – Many times.

Thanks again to Kaiser Permanente, and especially Judy Derman, Senior Practice Leader, Internet Services Group, and Kate Christensen, MD, Medical Director, Internet Services Group, for letting me sit in, and letting me share what I saw here. I think it’s useful to have this snapshot out there for leaders who are moving the practice of medicine forward in a patient/person/family-centered way.


Ted, Thanks for your perspectives about developments in leading edge organizations. I'd be interested in your thoughts about how much/what is transferable to mainstream health care in America, i.e., organizations other than Kaiser or Group Health where financing and delivery are not integrated. What lessons carry over, and which ones don't?

Hi Vince,

Well this exactly the question that prompted me to give up my role doing this at Group Health for 6 months and go into the rest of health care, because I get it asked of me so often.

I have been pleasantly surprised to find that much of what is being done here is probably transferable, definitely more than I or anyone asking your question likely thinks. The reality is that patients and physicians want to receive and deliver great care.

I welcome you to follow along and ask about specifics as I go. Anything specific based on what you see here so far?

Thanks for the input…Ted

Ted Eytan, MD