E-Medical Records Get Marketing Makeover

Duke University will try to convince consumers of the benefits
When the national Do Not Call Registry began last year, tens of millions of people signed up in a matter of months. The incentive was clear: eliminating dinnertime telemarketing calls.

Duke University hopes to spark similar enthusiasm about not having to fill out the same annoying medical-history forms every time a patient sees a doctor. Last week, a team at Duke's Fuqua School of Business began evangelizing the value of electronic medical records in an effort to prompt at least 20 million people to participate in the Health Data Exchange initiative.

Duke's strategy is to build consumer interest in electronic medical records before the technology is in place to widely share them. The thinking is that the health-care industry, slow so far to embrace information technology, needs a kick-start from consumers demanding its benefits. "There's been no national market force pushing electronic health records to consumers," says Brian Baum, Duke senior scholar and director of the Health Data Exchange and former chief marketing officer at Cap Gemini Ernst & Young.

Duke's vision is a national health-data exchange that lets consumers create and access their electronic health records, Baum says. Consumers provide their medical information, which is supplemented by clinical information from doctors and health-care providers who participate in the exchange. To pay for it, Duke hopes to sell access to aggregated data to pharmaceutical companies and biomedical firms developing new products, and possibly to public-health officials. Individuals would decide whether to let their data join the aggregate pool.

The United States and United Kingdom have very different approaches to electronic records
United States United Kingdom
Privately run, state-supported health system State-run health-care system
Feds encouraging more IT; no mandate Requiring E-records; starting system in England
Funding for small pilots and a major Defense Department effort $17 billion over 10 years for massive E-records system
This consumer-led, private-sector approach to national health-care records is in stark contrast to Great Britain's strategy. The government-run health-care system for England is attempting a $17 billion IT project mandating electronic health records and creating a national network for accessing them.

The U.S. Department of Defense also is building a clinical data warehouse. Its Composite Health Care System II project will bring data from electronic medical records of nearly 9 million military personnel and their dependents into a central data warehouse, which government agencies will be able to tap to analyze trends, such as the effectiveness of medical treatments, or to monitor signs of possible epidemics, says Larry Albert, senior VP of Integic Corp., the prime contractor on the project. The government doesn't plan to give data access to private companies.

The Duke campaign will highlight the benefits of electronic health records, such as reducing repetitive paperwork for patients and possible lower costs by avoiding duplicate medical tests when doctors don't have access to paper-based records, Baum says. He wouldn't say what funding the Duke group has, but the campaign will rely foremost on businesses and groups such as the American Association of Retired Persons to spread the word.

As for the technology behind the exchange, Duke hopes to piggyback on existing pilot programs. Several regional health data-exchange efforts are far enough along to show that, while effective, technology and process hurdles await a national exchange. A central repository faces the question: Who's responsible for ensuring the data is current?

"Doctors don't want to make decisions about patients based on old information," says Phil Greene, deputy director of operations at the Santa Barbara Regional Health Authority, which runs California's Medicaid program and uses a data-exchange system operating in the Santa Barbara area.

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