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10/1/2008
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Wal-Mart Rolls Out E-Health Records To All Employees

The retailer is the first Dossia employer coalition member to offer the consortium's personal health record system in volume to employees.

Initially, Dossia aimed to begin providing employees with PHRs in 2007. However, work on the project hit roadblocks several months into the effort when a legal brawl broke out after the original prime contractor of the system, nonprofit Omnimedix Institute, allegedly missed development milestones and Dossia allegedly withheld scheduled payments.

The dispute between Dossia and Omnimedix was later moved from the courts and into private arbitration. Dossia in September 2007 then forged a fresh development partnership with Children's Hospital Boston. The underlying capabilities of the Dossia PHR system is based on Indivio, an open source, scalable platform Children's Hospital built for its patients in 1998.

Except for Wal-Mart, most other coalition members are planning to wait till after their 2008 open enrollment season to offer the PHRs to employees because workers already have an avalanche of information to sort through as they're making their benefit choices for next year, Evans said in an interview with InformationWeek.

Dossia has been building its architecture in three layers, said Evans. That includes exporting into Dossia's repository patient data from health plans and pharmacies that work with Dossia member companies like Wal-Mart.

Eventually, the Dossia repository will also include data from other health institutions, like health care providers and labs, he said.

The second layer involves Dossia storing and securing that information, which is "patient-controlled." That means employees decide who can look at their PHR data, and whether to share it.

The third layer involves applications that "sit" on top of Dossia. In Wal-Mart's case, that includes WebMD personal health applications. Wal-Mart employees will access their Dossia-powered PHRs through personal health accounts offered by WebMD.

"That's the first of many tools," that will be coming from third-party companies like WebMD, he said. "Over time, we will have other data feeds, more applications sitting on Dossia," he said.

In addition to Dossia's current members, other employers have expressed interest in providing its workers with Dossia PHRs, Evans said. "It's clearly our goal" to attract other members to the consortium. "We've maintained dealings with many companies that prefer to let the founding members do the heavy lifting" during the development and initial rollout of the Dossia PHRs, Evans said.

Dossia does not have plans to enter any partnerships with Google or Microsoft in their consumer-oriented PHR efforts, said Evans. "Dossia is a nonprofit," he said. "I'm paid to house the data for associates, not make money," he said. Clumping the PHR strategies of Google, Microsoft, and Dossia together under one umbrella is "like saying that soccer and football are the same because guys are chasing a ball around," he said.

The majority of Dossia's development staff is based in Cambridge, Mass., where Dossia's "technology hub" is not far from Children's Hospital Boston. There's also a small Dossia team in Portland, Ore.

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