Substance Abuse & Mental Health Services Administration

CMHS Consumer Affairs E-News
July 5, 2005, Vol. 05-99

Centers for Medicare & Medicaid Services Special Open Door Forum:
Personal Health Records

July 21, 2005 2:00 PM - 4:00 PM (Eastern Daylight Time)

Giving beneficiaries better, more personalized information to make informed health care decisions is a key component to improving the quality of health care in the nation. This Special Open Door Forum will address a new initiative at CMS to help achieve this goal: enabling beneficiaries to use their Medicare information in personal health records (PHRs).

CMS currently provides increasingly detailed information on the quality and prices for a broad range of services such as prescription drugs, and information about health care providers in their area. CMS also recently launched the Medicare Beneficiary Portal demonstration project, which is being implemented nationally on a rolling basis during 2005. The portal is designed to give beneficiaries more control over their own health and health care through electronic access to all of their information related to their Medicare benefits, such as eligibility status, use of preventive benefits, and utilization of other covered Medicare services. It is one of the several initiatives put forward by HHS Secretary Mike Leavitt and CMS Administrator Mark McClellan in response to President Bush's call for Americans to be able to access their health records electronically within 10 years.

A new trend in using such information - Personal Health Records - is emerging. CMS is working to help Medicare beneficiaries to take advantage of that trend. A personal health record (PHR) is a collection of health information, electronic in format, which is specific to an individual and controlled and freely accessed by that individual. It may contain medical information such as laboratory test results and allergic sensitivities, insurance information such as enrollment and benefits, and may incorporate the ability to generate health care suggestions personalized for that individual. It differs from an Electronic Health Record (EHR) in that it is owned and/or controlled by the individual, not the provider, and can contain significantly more information beyond the medical history. Currently, PHRs are supported by online health companies, consumer groups, and many other organizations.

CMS is determining how it can make a beneficiary's Medicare data available for use in a beneficiary's PHR, with the consent and control of the beneficiary and with appropriate security and confidentiality protections. This information could substantially increase the richness of a Medicare beneficiary's PHR, helping to improve health as well as support the care decisions made between patients and health care providers.

For this Special Open Door Forum, the agency is inviting stakeholders in the health care system - including the perspectives of physicians, beneficiary advocates, ehealth systems, and other providers and payers - to discuss the role that CMS might play in supporting the development and adoption of PHR technologies.

To facilitate this discussion, we will present some of the latest findings from the National Committee on Vital and Health Statistics (NCVHS) hearings on this subject, as well as an overview of current industry status. CMS will then moderate a panel discussion of industry leaders representing health plans, providers, and beneficiary advocacy organizations. Participants both in person and on the phone will then have the opportunity to provide CMS with their input, ask questions, and participate in an open discussion with CMS staff and the panelists.

Some of the general topic areas which we would like to discuss include:

A. What are the important pieces of data CMS should provide for PHRs?
Medicare data include information on eligibility, demographics, enrollment
in health plans, utilization, and payment status information. Which are
most important to include in the CMS support for PHRs?

1 Should CMS provide "processed" beneficiary data for such services, or
should PHR services use claims information as is?

B. What should CMS' role be in the PHR effort?

How can CMS best accomplish secure and effective data linkages to
existing PHR services, with beneficiary permission and control?
Should CMS provide some PHR-related services directly, and if so which
ones? For example, CMS currently enables a beneficiary to find out if he
or she is eligible for expert-recommended screening tests that are
covered by Medicare.

C. What can CMS do to promote the availability and use of PHRs by patients
and providers?

With whom should CMS collaborate?

1 What are the best mechanisms for collaboration to develop support for
PHRs for Medicare beneficiaries?

D. What are the primary privacy and security issues to be addressed?

How can patient control and data security best be maintained?

We look forward to your participation in this important session.

Open Door Participation Instructions:
There are 2 ways to participate, by phone or "in-person".

1. To participate by phone:
Dial: 1-800-837-1935 & Reference Conference ID: 6586606 (Persons participating by phone do not need to RSVP.)

Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html.

A Relay Communications Assistant will help.

2. To participate in-person:
If you intend to participate in person, RSVP is required:
Please send a reply to this email by close of business Monday, July 18, 2005 to CMS SpecialODF@cms.hhs.gov. Please include the initials "PHR" in the subject line of your message, and send us the following information:

a) Your full name
b) Your organization or representation
c) Your contact information (phone and email)
d) Special needs information

Location information:
ADDRESS:

CMS Single Site Building
Multipurpose Room
7500 Security Boulevard
Baltimore, MD 21244

ENCORE:
"Encore" is a recording of this call that can be accessed by dialing 1-800-642-1687 and entering the Conf. ID # 6586606

The recording begins on Monday, July 25, 2005 and expires after 4 business days. *************************************************
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The Center for Mental Health Services is a component of the Substance Abuse and Mental Health Services Administration, United States Department of Health and Human Services.