# Presentation: 263047

## Registration Summary & Medication History - A Personal Health Record (PHR) Pilot 

- For Medicare BeneficiariesOffice of E-Health Standards and Services

***AHIC Consumer Empowerment Work Group ***
***December 5, 2007***

## Brief History of CMS PHR Endeavors

- 2005 RFI soliciting public feedback on CMS’ role with regard to PHRs (over 50 responses).  CMS should:
- make Medicare data available
- focus on privacy and security
- NOT build its own PHR
- 2006 Feasibility test using  Medicare claims data:
- Successfully tested the transfer of Medicare claims data  into existing internet-based PHRs
- Claims data translated into plain english/consumer friendly language

## Consumer Empowerment Work Group Charge to CMS (2006)

*“**HHS, through CMS, AHRQ, other interested Federal agencies, and private-sector partners, should pilot programs that measure and demonstrate the value of an electronic registration summary and medication history to patients with chronic disease and their clinicians.” *
- Challenges:
- Define “value”
- Identify PHRs (clipboards) that were both available to and in use by patients and clinicians define
- Identify PHRs that had a market for Medicare beneficiaries and those with chronic diseases
- Identify willing partners for the pilot
- Determine how outreach would be conducted

## Registration Summary & Medication History Personal Health Record Pilot

- Voluntary study with Commercial Health Plans offering a Medicare Advantage and/or Part D Drug Plan
- Participating plans already offer a PHR to commercial members
- Some plans already offer the PHR to Medicare members (eg Kaiser) because of PHR model
- Other plans have recently extended availability to Medicare members
- The Office of the National Coordinator (ONC) provided funds to AHRQ for the formal evaluation of the pilot
- AHRQ will manage the evaluation contract and products
- Pilot officially launched June 2, 2007

## Registration Summary & Medication History Personal Health Record Pilot (con’t)

- Four plans active as of June 2007:
- HIP USA (New York)
- Humana
- Kaiser
- UPMC (Pittsburgh)
- Three additional plans launched October 2007
- BCBS Arkansas
- BCBS Louisiana
- Medcore
- Additional participants expected in 2008
- BCBS South Carolina
- BCBS Regence (Oregon)

## Registration Summary & Medication History PHR Pilot - Requirements

- Content
- Basic demographics
- Medication History
- Diagnoses, Procedures, other encounter information
- Functionality
- Support use of claims data to populate tool
- Print reports (eg Medication list, diagnoses)
- Provide access to others (caregivers, providers)
- Features
- Health Assessments
- Links to educational materials and resources

## Registration Summary & Medication History PHR Pilot - Evaluation 

**Evaluation will be quantitative and qualitative  **
**Utilization Statistics**
- Number of registrants
- Number of repeat users
- Other demographics (age, sex, disability etc)
**Focus groups and/or surveys of stakeholders to assess:**
- Ease of use
- Use of medication history feature specifically
- Perception of privacy and security features
- Favored functions and desired functionality
- Perceived value for communicating with providers
- Perceived value for managing health conditions
- Most effective outreach methods (to impact adoption)

## Registration Summary & Medication History PHR Pilot – Utilization

- Approximately 230,000 Medicare Plan members are registered for one of the four PHRs (as of November 2007)
- Caveat: PHR registration is not solely the result of this pilot, nor is it all new since June 2007
- Total number of Medicare PHR registrants by plan:
**HIP USA**:  789 (150 repeat users)
**Humana:**
- 4, 695 new Medicare registrants since June 2007 (2,124 repeat users)
- 27,000 registered Medicare users prior to the study launch (11,000 repeat users)
**Kaiser:**  196,000 (89k repeat users)
**UPMC**:  105 (33 repeat users) - new Medicare registrants since June 2007

## Mymedicare.gov 

## Mymedicare.gov 

## Mymedicare.gov 

## Next steps for the Registration Summary Medication History PHR

- Evaluation activities through June 2008
- Identify and review existing studies of PHR utilization and value perceptions
- Conduct focus groups
- Develop and implement consumer surveys
- Compile and track quantitative statistics
- Present interim final report and recommendations to AHIC in December 2008

## Other CMS PHR Initiatives 

- Medicare Fee-for-Service Pilot  (official launch expected in January 2008)
- Will test outreach to, and adoption of PHRs by FFS Medicare beneficiaries
- Target 100k beneficiaries in South Carolina
- Use existing PHR – HealthTrio
- Medicare contractor to provide claims data – Palmetto
- Office of the Assistant Secretary for Planning and Evaluation (ASPE) has funded and will oversee the FFS Pilot evaluation
- Funding for pilot only available for 12 months
- Infrastructure design
- Identify and document business and technical infrastructure requirements to enable Medicare to support PHRs for beneficiaries

## Questions & Discussion

- What can we learn from this pilot?
- How consumers learn about the availability of a PHR?
- How easy or difficult it is to navigate these tools?
- How often do consumers access and/or use their PHR?
- Who else is given access to PHRs?
- Is there information Medicare consumers do not wish to share with others?
- What other questions should we ask the Medicare user community (beneficiaries and caregivers)?
- What questions should we ask the non-users?