Friday, July 13, 2007

Who'da thunk it? -- Personal Health Record project with big corporate sponsors not working out so well ...

The Dossia PHR (Personal Health Record) project, whose corporate members include Wal-Mart and Intel, is in a bit of trouble.

I predicted problems might arise in previous Healthcare Renewal posts:

"Big employers plan electronic health records (and a manned Mars expedition as a warmup?) "

"On Intel's and Walmart's prescription for Healthcare IT."

Here is the latest on what appears to be a significant debacle in the making:

Information Week: Major E-Health Records Project Unravels Into Legal Battle

Marianne Kolbasuk McGee, July 11, 2007

Electronic health systems are supposed to help improve health care. But apparently, if you're involved with a big project to build an e-health records system, it can be harmful to your own health. Side effects may include headaches, lost sleep, and lawsuits.

Especially when electronic health systems are not your core competency...

Those are just some of problems being faced by those involved with the ambitious e-health record systems project launched in December by the Dossia Consortium, an employer coalition that includes Wal-Mart, Intel, Pitney Bowes, Applied Materials, British Petroleum, and Cardinal Health.

Dossia's ambitious project to provide e-health records to more than 2.5 million employees, retirees, and dependents is unraveling, at least when it comes to the relationship it has with Omnimedix Institute, the nonprofit organization that Dossia hired to develop the system, which was to include a massive, federated data warehouse.

Yes, a project to provide e-health records to more than 2.5 million employees, retirees, and dependents is just a piece of cake for the Intels and Wal Marts of the world. After all, they track 2.5 million widgets with ease.

Legal papers are starting to fly. A temporary restraining order was quietly filed in late June by Dossia against the Portland, Ore.-based Omnimedix in the circuit court of the state of Oregon for the county of Multnomah. According to court papers filed by Dossia, Ominmedix is temporarily restrained from filing any suit of its own except under seal.

Just what the public needs to inspire confidence in Personal Health Records sponsored by employers...

A source familiar with the situation says trouble had been brewing for months, even though the alliance between Omnimedix and Dossia is only about six or seven months old. The source says Omnimedix was seeking payment from Dossia, but that Omnimedix had failed to provide "deliverables" for the project so far, and that Dossia was demanding money back that it had already paid to Omnimedix. Neither [Onnimedix CEO] J.D. Kleinke nor a Dossia spokeswoman would comment on those allegations.

Kleinke said that under the contract signed last year between Omnimedix and Dossia, Dossia was to pay Omnimedix $15 million to build a system that would allow Dossia members' employees to access their own personal health records via the Web. By mid-2007 -- about now -- some Dossia members were expected to begin using the system. Kleinke admits that has not happened and the system hasn't yet gone online. Kleinke says details discussed with InformationWeek about Dossia appear in "public documents," including court papers related to the restraining order, and that he's not revealing confidential information.

Does the word "boondoogle" apply here?

I met J.D. Kleinke in the past. We were on a presentation panel in 1999 at a Capitol Hill healthcare conference sponsored by the Ethics and Public Policy Center in Washington, D.C.

J.D. is a medical economist and author of "Oxymorons: The Myth of a U.S. Healthcare System" among other books. He seemed to have an excellent understanding of the sociotechnical problems in healthcare IT, so although I have no further information beside the Information Week article, my gut feeling is that the problems are likely coming from the big-corporate side.

While the Dossia effort is ambitious in that it's the largest employer coalition currently attempting to provide workers with personal e-health records, Dossia isn't alone in the problems it's encountering in getting its e-health system moving along.

The e-health record landscape is
littered with promising but complex projects that have had disappointing outcomes or quiet deaths because of a number of factors, including lack of funding, underutilization by doctors and others, concerns about patient privacy, medical liability, competition, and technology glitches. (and incompetence? - ed.)

You don't say...

-- SS

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