A Social Network for Your Doctor, Pharmacist and Insurer

By Kendra Marr
http://www.washingtonpost.com

Imagine a virtual health clinic: Your lung doctor and heart specialist can pull up your online medical profile and chat, via instant messenger, about your medications. You schedule checkups online, create a wellness journal or even rate your general practitioner.

WellNet Healthcare, a Bethesda health management company, is launching the beta version of this social network, Point to Point Healthcare, this month. Since 1994, WellNet has built its business collecting detailed data on employees’ medical and pharmacy activity so that companies can better evaluate their corporate health plans.

WellNet’s clients nationwide — including Washington-area firms such as Peterson Cos., Dewberry, and Kiplinger Washington Editors — will be among the first to test-drive the new system. It lets employees create a personal network uniting their insurance claims manager with multiple doctors and pharmacies to better coordinate treatments. An online concierge helps workers find new specialists, and a message system reminds them to pick up prescriptions.

Whether it all works remains to be seen.

WellNet must persuade its network of 300,000 primary-care doctors to start working with patients on the Web.

“It depends how simple it is to use these online tools,” said Joseph Heyman, chairman of the American Medical Association’s board. “Most physicians right now are on a hamster wheel. They have trouble keeping up. If it means extra work, and it’s not a time-saver, they’re generally not interested.”

Privacy advocates worry about the security of Web-based medical records. Deborah Peel, founder of the Patient Privacy Rights Foundation, said it is impossible to regain your privacy should the intimate details of your health be stolen and made public.

“It’s not like financial identity theft, where someone steals your Social Security number, date of birth, where you live. You can fix that. It takes time and it’s a nightmare, but it can be corrected,” Peel said. “There isn’t any way to fix a violation of your sensitive health records.”

And others have reservations about what information employers will have access to. WellNet said it plans to collect anonymous data allowing employers to see, for instance, how many people are using certain drugs and specialists — something it already does under its existing systems. The difference is that it would now do so in real time by monitoring the social network. If a large percentage of a workforce requires expensive diabetes medicine, but employees aren’t regularly filling prescriptions, WellNet said an employer can lower the co-pay to make the drugs more affordable.

“It’s just common sense,” said Keith Lemer, WellNet’s president.

Since WellNet deals with small and mid-sized companies, some worry that it may be possible to uncover the identities of those nameless employees. Or, instead of helping employees gain access to certain medications, they could be coerced into buying cheaper, less-popular generics.

“What if you have a very expensive employee who takes tons of medicine? What does this mean?” Pam Dixon, executive director of the World Privacy Forum, said about efforts similar to WellNet’s. “These are very sensitive areas.”

WellNet said it knows it is diving into turbulent waters. The company said its online workspace will be guarded by the legal protections specified by the Health Insurance Portability and Accountability Act (HIPAA) and the same online security used by the banking industry. Much like Facebook users, Point to Point members, who must opt in, can control who can see the different parts of their medical profile.

WellNet isn’t alone in pursuing such a network. The online health industry is growing rapidly. Internet titans like Google and Microsoft have put resources toward popularizing online medical records. Insurers have been adding more online tools to help their members switch doctors and check co-pay information. Arlington start-up HealthCentral, an online destination for medical information, links people with a particular disease to relevant doctors and blogger-patients.

Revolution Health, founded by former AOL chairman Steve Case in the District, aims to be a one-stop shop for health, offering online tools that help individuals manage their own well-being. For employers, it runs a telephone-based service where members can get help resolving insurance quarrels, scheduling appointments and answering health questions — what Case once called “AAA for health care.”

Janice Algie, Peterson’s director of human resources, said she wondered if her employees would use more online tools like Point to Point.

“It’s difficult to get them involved in their own health care,” she said. “Every time a claim is processed, whether it’s health insurance and dental insurance, it’s submitted and tells them what they owe. I can’t tell you how many employees look at those. Even though they have online access, they still don’t look at them.”

But perhaps it’s generational, Algie said. With few entry-level positions, about 45 percent of Peterson’s workforce is age 40 and above.

Dell Nunaley, Dewberry’s human resources director, said WellNet’s program might help guide employees, who are often bombarded with too many health-care choices.

For now, to entice more users, WellNet will give companies the program for free if they transfer their pharmacy benefits to WellNet. When it opens this service to others early next year, it will start charging a licensing fee.

“It’s all about productivity,” said Henry Cha, chief executive of Healthcare Interactive, a Glenwood software company that developed Point to Point. “You’re in a rat race. You already do online banking. You shop online. You make payments online, just to make sure nothing falls through the cracks.”

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