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By Cassimir Medford

A coalition of businesses including Intel and Wal-Mart will announce a plan that they believe will spur the development of a massive healthcare database in the United States, a digital Holy Grail that has been under debate for more than a decade.

According to Wednesday’s edition of TheWall Street Journal, Intel, which employs almost 100,000 people, and Wal-Mart, the largest private employer in the U.S., plan to construct a database that will house the health records of their more than 1 million employees.

Hospitals, pharmacies, doctors, and insurers will have access to the database, which will be able to process the medical cost-sharing based on the health plans of the employees.

The healthcare industry has proven adept at adopting medical technology and a little less adept at adopting new drugs, but information technology has emerged painfully slowly in hundreds of systems that don’t communicate with each other.

For the most part, healthcare information systems have remained paper based, with all the errors involved in paper handoffs among doctors, nurses, hospitals, and pharmacies.  

Physician Heal Thyself

President George W. Bush’s administration has made healthcare information systems automation a priority, so new rules governing systems integration and standards have been bandied about, but the industry still seems incapable of doing the integration itself.

It lends perverse new meaning to the old saying, “physician, heal thyself.”

But an employer-owned medical database for employees opens a Pandora’s Box of privacy and ethical issues.

Plus the presence of Wal-Mart as one of the commercial leaders of the online patient’s records movement could present some drawbacks.

“Wal-Mart’s track record on the matter of healthcare benefits for employees has been less-than stellar so they are liable to get a lot of negative publicity for this database,” said Charles King, principal analyst with PundIT Research.

“If they are doing this for all the right reasons, then more power to them,” he added. “On the plus side, Wal-Mart’s $4 plan for generic drugs has been very well received.”

Can of Worms

There are also issues around discrimination from the employer, other potential employers, insurance companies, etc., based on an employee’s health records, which will be digitized, organized, and accessible in one place.

“People understand the benefits, but they are concerned about the Big Brother aspects that are troubling to a lot of people,” said Roger Kay, principal analyst of Wayland, Massachusetts-based Endpoint Technologies Associates. “But there is a lot of medical fraud and mismanagement with doctors, pharmacies, and hospitals all gaming the healthcare system.”

Medical fraud, duplicate treatments, and duplicate testing account for a high percentage of the cost of healthcare, but a solution has been long delayed because no single segment of the healthcare industry takes overall responsibility for the shortcomings.

“It’s a kind of gentle fraud where people feel almost justified because the system is broken,” said Mr. Kay. “But there seem to be very few in the industry willing to take overall responsibility.”

Under the Intel/Wal-Mart plan, employees will have ultimate control as to who accesses their records, according to the Journal, and they will have full ownership of those records.

The coalition hopes the healthcare industry will get on board, which could make the database the first or second phase in the general construction of a national patient health records database.