EHR, PHR or something in between? UnitedHealth’s tech venture prompts skepticism and intrigue

With plenty of cash on hand and a backlog of health IT acquisitions, the country’s largest health insurer is carving out its own space in the health IT sector with a new medical records platform.

But experts said it's not clear whether UnitedHealth can break through in an industry where companies have historically struggled with consumer engagement and interoperability.

Its plans are still shrouded in ambiguity, but UnitedHealth is poised to launch its own version of an electronic medical record. During its third-quarter earnings call last month, CEO David Wichmann said the company plans to release a “fully integrated and fully portable individual health record that delivers personalized next best health actions to people and their caregivers," indicating the solution would have some kind of baked-in analytics.

But the insurer appears to be targeting providers as well “in a format that looks a little bit more like their EHR.”

Exactly how that solution fits into the current health IT ecosystem remains unknown, but industry insiders say its unlikely UnitedHealth is going after the traditional EHR market where providers have generally settled into their EHR-of-choice and the rip-and-replace market is slowed considerably following a rash of installs during the Meaningful Use era.

“We don’t need another crappy, poorly designed ‘Model T’ EHR; we have plenty of those,” Dave Levin, M.D., chief medical officer at Sansoro Health and the former chief medical information officer for the Cleveland Clinic told FierceHealthcare.

More likely, the company is focused on an “Apple-type strategy” according to Matt Guldin, a senior analyst with Chilmark Research, who said a traditional EHR would be “complete madness.”

“My sense is they are doing this for the consumer play and the consumer issues,” he said. “They will try and integrate with the Optum consumer portal that they use on the health insurance side and they are looking to gather up all the data that they can. They are looking to do this to create a more consumer-friendly marketing message.”

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That echoed analysis from Steven Halper, an equity researcher at Cantor Fitzgerald, who wrote in a recent investor note (PDF) that the new product “should be viewed as a consumer engagement tool and not as a threat to legacy provider EHR products."

UnitedHealth has a bench of acquisitions to build on. Wichmann said the company is using Rally as its jumping off point, a platform that has 20 million registered users. Optum bought a majority stake in the company in 2014 when it was still operating under the name Audax Health. By February 2017, it bought the company outright.

Several other acquisitions over the last decade could play a role in the new offering. In 2013, the company bought Humedica, a Boston-based health data-analytics company. And in August 2017, UnitedHealth acquired CentriHealth, which developed an “individual health record,” described as “a longitudinal holistic health file.”

Reaching even farther back, in 2010 the insurance giant bought Axolotl, a health information exchange provider, and Picis, a health IT and analytics company that focused on high-acuity hospital departments like the OR and ED.

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Those past acquisitions—combined with the insurer's pharmacy- and provider-focused spending spree—could all factor into UnitedHealth’s newest offering. Whether that skews more towards a “personal” or “individual” health record, industry experts agreed that its hard to ignore the firepower of UnitedHealth. But they also expressed doubts that the company could overcome many of the same issues that health IT companies have encountered around usability and interoperability.

“You have to design something really elegant and usable and that’s not easy to do; we don’t have a good track record of doing that in healthcare,” Levin said, adding that he has “no reason to believe [UnitedHealth] has great skills in human factors engineering and user interface design.”

And in order to make an impact, Guldin said the company will have to create a tool that goes beyond simply integrating data from a consumer portal with claims data.

“If it’s just an information sink or a place to store data, that’s not a terribly interesting or new concept,” he said.