Marriott has taken one of the boldest, large-scale steps to implement integration of an outsourced PHR network. (Who's next? Best Buy? Starbucks? An AMC/hospital group?)
Financially, it makes all kinds of sense: an employer that operates in a 24-7, customer-oriented industry has a lot to gain by simultaneously enhancing employee wellness and reducing costly absenteeism.
Click here to read the Information Week piece.
Marriott's program, designed by ActiveHealth (an Aetna subsidiary), is quite a bit more than a passive central repository for individual health and wellness data.
ActiveHealth's CareEngine system, staffed by 20 full-time docs, proactively monitors the exchange of data between providers and patients.
Employees take an online 'health risk assessment' and the system begins compiling PHD.
The system scrubs clinical info, and compares it to other PHD (claims from physicians, Rx pickup/refill).
If the program notices an error, such as medication contraindication, or can discern a 'better' plan of care, it may send a notice to an employee's physician (via phone, fax, or certified letter -urgent issues necessitate a phone call). Then it copies the staffer on the contents.
Click here to watch a video from ActiveHealth showing how the system works (very basic).
From the Information Week article:
"But unlike some of the personal health records offerings being rolled out by other employers, the system deployed at Marriott also taps into a sophisticated clinical rules engine that looks to avert potential medical mistakes or gaps in care that could lead to serious complications and costs.
When those gaps or potential mistakes are identified by the system, doctors are alerted by phone, fax, or letter with a "care consideration" notification that might recommend the doctor prescribe a different treatment, order additional tests, or make another change to the patient's care. The member employee -- or patient -- is also alerted.
According to ActiveHealth, the employer doesn't get copies of care notices - they receive aggregate info showing, for example, 70% of workers have high blood pressure.
"The access we have to medical information is broader than most doctors have," says Reisman. ActiveHealth has "codifed" thousands of clinical standards and evidence-based best practices."
And what will Marriott, Aetna, ActiveHealth, and the Marriott employee do if (and inevitably when) a physician determines a change in patient care is not appropriate? Fine the doc? Impose some other sort of penalty?
What sort of liability does Marriott engender when a physician who has not seen their employees mistakenly receives personal health data via CareEngine and ActiveHealth?
What happens if Marriott employees refuse to join the CareEngine program?
Will signing your personal health data over to Marriott and CareEngine's physicians be a condition of employment, like consenting to a background check, for future employees?
It's not just Marriott - ActiveHealth has 100 other corporate clients.
Apparently Marriott's hoping the carrot approach will work:
"Marriott also is developing an incentive plan to encourage employees to complete a
My HMO already dictates, to some extent, which physician I visit based on partnerships they've arranged. I'm not so sure I want my employer integrally involved in determining the quality of care.
What do you think? Does the CareEngine program seem like a step away from consumer-directed care, or is this a victory for H2.0?
Marriott is giving workers a way to store personal health data but placing an additional layer between consumer and care provider - does this layer hinder or help grow that relationship?