We're rolling out our slate of eHealth Innovators. Dossia is the 7th of 10; see the unfolding list to the right.
Dossia, a Portland, Oregon-based non-profit consortium of employers, is our #7 of ten eHealth Innovators of 2008. Here's our interview with them.
1). Dossia is now working with Children’s Hospital Boston. What drove this move?Dossia and Children’s Hospital Boston share a common vision of promoting widespread adoption of personally controlled health records (PCHRs).
For more than a decade, researchers in the Children’s Hospital Informatics Program (CHIP), based at Children’s Hospital Boston and affiliated with Harvard Medical School and with the Harvard-MIT Division of Health Sciences and Technology have been leaders in pioneering and promoting personal control of health information as a key to improving consumer health management and outcomes, and in developing rigorous, privacy-protective methods of ensuring patient control over their own medical information.
CHIP researchers developed Indivo, the world’s first personally controlled health record, in 1998. Children’s Hospital Boston is now collaborating with Dossia to adapt a version of the existing open-source Indivo system to provide secure, portable, personally controlled health records for use by employees, dependents and retirees of Dossia’s founding companies.
2). Give us technical details on Indivo – especially its architecture.
Indivo is a specific implementation of a PCHR that is web-based, ubiquitously accessible to the nomadic user, built to public standards, and available under an open-source license.
The Indivo software allows institutions to create and administer a PCHR infrastructure that exceeds the current requirements of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules.
Indivo is a three-tier system with a data storage tier, a business logic tier, and a user interface. Indivo’s unique implementation of the PCHR concept focuses on complete transparency and high security. All Indivo technical documents, including design concepts and source code, are freely available and accessible on the Internet, so as to foster collaboration and ecosystem innovation. Critical to interoperability and adoption, all design concepts, application programming interfaces and document formats are open and public. High security is enforced at all three tiers of the system and is a primary feature.
3). What companies do you have currently as members, and how might this change over the next twelve months?
Dossia’s founding member companies, Applied Materials, AT&T, BP America, Cardinal Health, Intel, Pitney Bowes, sanofi-aventis and Wal-Mart, share a common vision: empowering our employees to make smarter, more informed decisions about their healthcare. The founding companies formed Dossia because we believe it will help make the healthcare system more efficient and effective -- reducing medical errors, eliminating waste and reducing costs to healthcare providers and employers which provide health benefits to employees.
Rather than taking separate steps as individual companies, we are collaborating to provide employees with access to their health information so that they are empowered to make better informed healthcare decisions. We created Dossia, a not-for-profit, third-party organization, which will provide employees with access to -- and control over --- their personal health information through private and portable electronic health records. Dossia’s primary goal is to create a Web-based infrastructure for the storing and managing of each employee’s personal, private and portable health information. Dossia will work with the sources of that health information to facilitate the transfer of electronic copies for each employee.
Through Dossia, Founders are able to leverage our combined influence to break down barriers to health information, which will help drive consumer-initiated change. Dossia is actively pursuing discussions with like-minded organizations that are interested in joining the Founders and dedicated to empowering employees to make smarter, more informed health related decisions.
4). Do you have some early learnings from the beta process that you’d be willing to share?
Dossia’s implementation is currently under way. The system is being used by early adopters from Dossia’s founding member companies. The early adopters began participating in the pilot program in late 2007 and that member participation continues to grow as applications and services are added to the offering. Throughout 2008, Dossia will expand its efforts to build electronic bridges with healthcare providers, health plans and pharmacies. This effort will give Dossia users ongoing access to their health information. Additional users from Dossia’s founding member companies will be added based on individual founders rollout plans throughout 2008.
Additionally, Dossia is building links to multiple personal health applications that Dossia member employees can use to put their information to creative use via the Indivo platform.
5). PHRs have been bedeviled by weak adoption post-trial. How can this be remedied moving forward, and in what ways does Dossia address this? And how do you see the role of Employers regarding driving adoption?
Current PHR systems have one of two real barriers to adoption, either they require the patient to enter their own information or they are tied to a single source of information – a health plan or a hospital for instance. In the first case, the effort is still too daunting for all but the most determined consumers. In the second case, the information still provides an incomplete view of the patient. Additionally, consumers are wary of building a relationship with one company; they are not sure how else their data is being utilized and there are concerns about losing access to their information when changing plans or providers.
Dossia aims to solve both these problems by providing a broad range of data sources and a truly independent and portable solution.
6). What firms/organizations do you see as the principal competitors to Dossia?
Dossia is unique -- in its vision, mission and model.
First and foremost, Dossia is a non-profit organization.
Secondly, Dossia’s members are focused on:
- transforming the healthcare system in America;
- providing employees with access to -- and control over --- their personal health information through private and portable electronic health records;
- empowering our employees to make smarter, more informed decisions about their healthcare.
7). How does Dossia harmonize, if at all, with the ad-sponsored offerings from Microsoft HealthVault and others?
The Dossia model is not about driving profits, but about driving a transformation in the healthcare industry. Proceeds are reinvested to continuously improve the system.
Dossia’s infrastructure is open-source. It will be made available to personal health application developers who share a commitment to maintaining a consumer’s personal access to and control of their health information. In fact, Dossia’s infrastructure is designed to encourage vendor innovation for the benefit of patients and providers nationwide.
Read more in our 150-page SPOTLIGHT REPORT, updated each month. We carve out four discrete segments in eHealth, and tell you what's happening, how and why, including detailed revenue projections:
a. News/Search/Community
b. EMR
c. PHR
d. Digital Home Health.
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