UnitedHealth rolls out beta individual health record to 3 ACOs, touts promising early results

Shortly after announcing it would make a new in-house medical record available to 50 million members by the end of next year, UnitedHealth is already testing it out on select providers.

The company released a beta version of its new individual health record (IHR) to three accountable care organizations (ACOs) in early November, and the results so far have been promising, UnitedHealth CEO David Wichmann said during the company’s investor conference on Tuesday.

In the first week, the IHR “positively altered the course of treatment” for two patients, possibly saving their lives, he said.

One physician was able to confirm a “previously unmade diagnosis” using artificial intelligence embedded into the IHR, “dramatically modifying the patient’s treatment plan,” he added. Another practice eliminated the time spent by a nurse on staff to build a patient’s medical history manually.

“Our goal of reaching the 50 million people we serve with the IHR is no longer a question of if—it’s when,” Wichmann told investors, adding that the IHR will be available to all members in North and South America for free by the end of 2019.

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During its third-quarter investor call last month, UnitedHealth announced plans to provide a “fully individualized, fully portable” medical record to 50 million members but offered few details about exactly what that would look like. UnitedHealth executives offered a few more details on Tuesday, leaving the impression that the new IHR would complement, not replace, existing EHRs. As described, the solution appears to mimic a population health tool more than anything else, said Erik Bermudez, vice president of clinical and continuum of care at KLAS Research. And that market is already saturated with new companies looking to carve out their own position.

“They haven’t said anything new or described anything this market hasn’t already heard,” he said, adding that he talks to 15 to 20 new companies a week, the vast majority of which are focused on population health.

Wichmann—who repeatedly described the company as “restless”—acknowledged that building such an integrated solution is “complicated.” But he said the true impetus behind the solution goes beyond a technical solution to interoperability. UnitedHealth plans to use the IHR to push members toward high-performing practices, simplify information distribution into physician workflows, and create a closed-loop health information exchange unique to each consumer.

“We see the building of the IHR as one of the most transformative steps in significantly improving quality, eliminating practice pattern variation, and driving high consumer engagement in managing their health and modifiable lifestyle behaviors,” he said.

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In addition to 50 million members, the IHR will be accessible to 1 million care providers, according to UnitedHealthcare CEO Steve Nelson, who said the solution will connect “numerous EHRs” and unlock data “currently trapped in today’s fragmented healthcare system.”

IHR data will feed into UnitedHealthcare’s “nerve center,” a data hub that combines wearable, clinical and claims information and incorporates machine-learning models to offer real-time alerts and predictions.

“I believe IHR will become a valuable workflow tool that helps healthcare professionals deliver exceptional care,” Nelson said.

Executing on that will be the difficult part, particularly when it comes to connecting multiple EHR vendors and getting providers to buy in, Bermudez said. UnitedHealth is likely to encounter substantial barriers around policies and contracts with providers. And while early-stage ACOs and practices under the company’s umbrella may be the ideal testing site, the vast majority of providers are reluctant to take on financial risk.

“We’ve been talking about population health for five years and we haven’t really seen true evidence-based outcomes of organizations reaping the rewards,” Bermudez said. “There are not a lot of organizations raising their hand and saying ‘Look at my clinical and financial outcomes.’”

UnitedHealth’s long-term goals extend beyond patients and providers. Though Wichmann dodged a question about whether the company plans to monetize the solution—instead describing the IHR as a way to improve outcomes and lower costs by driving evidence-based medicine—he said UnitedHealth will eventually offer the solution to other health plans.

“Whether this would be offered to others on a multipayer basis, the answer to that is, absolutely yes,” Wichmann said, noting that the plan is to start with UnitedHealthcare and OptumCare entities with locations in 13 states. “Our intent would be to offer it broadly."