One of my Self-Generated Health Information Consortium Steering Committee members introduced me to the concept of a health record bank (HRB, though I have been thinking along these lines for awhile now as reflected in my “Transforming Health Research through Use of a Secure Health Data Cloud” presentation made in December 2011 in Saudi Arabia as part of my efforts to develop Quantal Semantics, Inc.). My investigation of this concept led me to the Health Record Banking Alliance as well as HRB business model and HRB architecture white papers about this concept for health information exchange. I followed up with Bill Yasnoff the founder of the HRB Alliance and he has been very generous with his time to explain HRBs as well as a specific business plan for moving forward with an HRB. I’ve asked many questions and I’m hopeful that this maybe the sustainability solution for self-generated health information exchange as well as for provider-generated health information exchange.
Unlike current efforts at providing health information exchange, an HRB is a store of all of an individuals health information in one account. Access to this information is controlled by the individual or their proxies (i.e. family members). Information is uploaded to the individual’s HRB account each time an entry is made in a healthcare provider’s EHR about that individual. This would include doctors notes, lab reports, etc. that update the information for the individual in those EHRs. The first provider that uploads information and creates the HRB account for the individual, gives that individual an account number from the HRB. The individual can then provide that account number to any of its healthcare providers, or on their online accounts of self-generated health information (i.e. from mobile health apps or health and wellness devices, etc.). This information is then all aggregated in the individual’s account where they are able to annotate it and control the sharing of that information.
An HRB would allow the individual to see all their information in one place, and when that information is needed it is efficiently located without any requirement for aggregating the information, as would be needed by current approaches to health information exchange. As a result, the HRB gives the individual better control over their health information, allowing the individual to not only control who sees any portion of their health information, but also the ability to annotate it and to monitor who actually accesses the information. Furthermore applications could be developed that would allow individuals to notify themselves or loved ones when their information is accessed, and if the information is accessed in some emergency situation by a provider, those family members who want to know about such an emergency can more quickly respond without waiting for a call from the emergency provider as they do today.
Furthermore, individuals who are interested in supporting research into disease could share their information, and they could potentially obtain funds for sharing that information from the organizations who want to access the information for research purposes. The possibility of generating income from one’s information will create a variety of business models that will promote the development of higher quality data and larger aggregates of data for improvements in research, and even better efforts to personalize medicine.
The challenge is to get the healthcare industry to support this effort, and Dr. Yasnoff has a solution for that as well. He proposes to use the funds generated from research uses and other applications sold that use this HRB platform, to support the implementation of EHRs by physician practices. A discussion I had last night with a physician practice management organization suggests that this would be a viable idea from their perspective.