When Social Features Meet Personal Health Records

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Employer consortium Dossia is adding new functionality to its personal e-health record system to improve engagement with users and help them better manage and improve their health.

The new Dossia Health Manager is an "intelligent" health management system that further extends Dossia's original e-personal health record capabilities beyond being a platform for individuals to store and track their health information to one that enables users' health data to become "actionable," said Dossia CEO Mike Critelli, in an interview with InformationWeek Healthcare.

The new system integrates game and social networking dynamics, incentives, and messaging in an effort to foster "sustained user engagement and behavior change," he said.

Dossia is increasingly migrating away from being "a pure health record system" to an intelligent platform with tools and applications to help employees better manage not only their health data, but their health, he said.

"We realized about 2-1/2 years ago that people want more than information, but tools to organize and act on the information," he said.

"We've been recognizing that self-insured companies have been asking for a return on investment" for the wellness and other programs they've been offering employees in hopes of reducing healthcare costs, he said. While employers often do a lot of discretionary spending on employee health risk assessments, wellness and prevention programs, and health coaching for employees, especially those with chronic illnesses, getting employees to regularly partake in healthy behavior promoted by these programs can be difficult. Also, employees often don't take advantage of these employer-sponsored programs.

The new platform can help nudge Dossia users to do so with reminders, and game-like activities to get them more engaged in tracking their health, whether it's a hypertension patient remembering to take daily blood pressure readings or a parent keeping on schedule with kids' immunizations, he said.

While employers do not have access to workers' Dossia health data, employers' health plans do process claims data that can indicate whether a patient is keeping up with refills for prescriptions to treat chronic conditions, and whether a patient is going to the doctor for recommended services. The Dossia platform can help employers and health plans devise benefit packages that incentivize healthy behavior, he said.

Based on information in an individual's Dossia health record data, the system can offer customized applications, such as tools and content geared to a person's chronic condition. For instance, if a patient is diagnosed as obese or pre-diabetic, the Dossia system may suggest recipes and health tips geared at helping the patient better control diet and weight as well as other factors that could help decrease the risk of actually developing diabetes or other medical complications.

The system also feature calendaring and messaging capabilities so that users can have reminders sent to themselves on their preferred mobile devices.

For instance, users can set up Dossia email reminders to be sent to them on their smart phones, to help remember bringing on asthmatic child's inhaler on vacation or having updated immunization records sent to their kid's summer camp.

New Dossia enhancements also include an improved user interface that "looks and feels" like other Web popular applications including social networking sites like Facebook, Critelli said.

Dossia has been bolstering the features of its personal health record system in recent months, including adding a medical term translator to help users better understand terminology that appears in lab results and other clinical information that often shows up in patient records.

The enhancements being offered by Dossia also help to further differentiate the consortium's online personal health record system from others, including Google's soon-to-be canceled Google Health offering.

"Google Health failed because it required consumers to do too much of the work in getting data downloaded," he said. Dossia aggregates data from multiple sources, including from users' health plans, healthcare providers, wellness and medical devices--while the platform's enhancements are increasingly providing tools to help users manage that data and act on it, he said.

Dossia was launched in late 2006 by a consortium of several large employers to provide e-health records to more than two million of their workers to help those employees better manage their and their dependent's health and wellness, with a bigger vision for those efforts to help control soaring healthcare costs.

Dossia members include AT&T, Intel, Wal-Mart, BP America, Applied Materials, Cardinal Health, Vanguard Health System, Pitney Bowes, sanofi-aventis, and Celgene. Of the 10 member companies, so far six have rolled out the PHRs to employees, said Critelli.

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